NPIMap

Organization Active NPI

Kennedy Orthopedic Services, Inc.

  • Surgical Physician Assistant
  • Tempe, AZ
National Provider Identifier
1841561859
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2765 Issued in AZ
Legal business name
KENNEDY ORTHOPEDIC SERVICES, INC.
Practice address
1819 E Yale Dr
Tempe, AZ 85283-2249
Phone
(602) 320-0335
Fax
(480) 248-8993
NPI assigned
Jan 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Mr. Ryan David Kennedy
Title
President
Phone
(602) 320-0335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 2765 AZ Primary

Addresses

Primary practice location

1819 E Yale Dr
Tempe, AZ 85283-2249

Mailing address

1819 E Yale Dr
Tempe, AZ 85283-2249
Phone (602) 320-0335

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1841561859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 E YALE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852832249",
            "telephone_number": "602-320-0335",
            "fax_number": "480-248-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 E YALE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852832249",
            "telephone_number": "602-320-0335",
            "fax_number": "480-248-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY ORTHOPEDIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-320-0335",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.