Cade Joseph Kennison

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

801 E Main St
Tishomingo, OK 73460-2351

Phone

(580) 371-3799

Fax

(580) 371-2056

NPI assigned

Sep 25, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pennington Creek Life House

  • Community/Behavioral Health Agency
  • Tishomingo, OK
  • NPI 1164771366
  NPD (past)
• Pennington Creek Lifehouse

  • Community/Behavioral Health Agency
  • Tishomingo, OK
  • NPI 1831464304
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1831525591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S MULDROW ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603278",
            "telephone_number": "580-371-3776",
            "fax_number": "580-371-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E MAIN ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602351",
            "telephone_number": "580-371-3799",
            "fax_number": "580-371-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNISON",
        "first_name": "CADE",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Patricia Jones, DO
• Janet Renee' Julian, DDS
• Chandra Dawn Justice, MMP
• Danielle Ophellia Kemp, BS, BHRS
• Georgia Kemp
• Alisha Khan, CF-SLP
• Carol Sue Kimbro, LPC
• Jesa Leigh King
• Ellen Cierra Kleinert
• Robert D Laing

• All providers in Tishomingo, OK
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.