Trisha Lynn Kennedy

Key facts

NPI

1831782341

Entity type

Individual (NPI type 1)

Primary specialty

Nurse's Aide 376K00000X

Practice address

24276 166TH Airport Road
Eagle Butte, SD 57625

Phone

(605) 964-7724

NPI assigned

Feb 16, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 16, 2021.

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1831782341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1723",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251723",
            "telephone_number": "605-200-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 166TH AIRPORT ROAD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TRISHA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Butte, SD

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• Alexis Jones
• Glen Jorgensen, RN
• Ellen Jung
• Bailey Jo Keckler
• Deleen Jean Kougl, CNP
• Tausha Kae Kraft, RN, BSN
• Tonia Beth Kraft, RN
• Monte Loren Kranz, D.D.S.
• Stepheny Ellen Lamont, RN

All providers in Eagle Butte, SD · Nurse's Aide in South Dakota