Active NPI
Lara Rae Kennedy, PHARMD
- Pharmacist
- Shakopee, MN
National Provider Identifier
1841580867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118001
- Practice address
- 1664 Bedford LN
Shakopee, MN 55379-4449 - Phone
- (952) 913-6166
- NPI assigned
- Apr 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5343 | SD | |
| Pharmacist | 183500000X | 118001 | MN | Primary |
Addresses
Primary practice location
1664 Bedford LN
Shakopee, MN 55379-4449
Mailing address
22549 W 72ND Ter
Shawnee, KS 66227-2624
Phone (952) 913-6166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118001 | MN | MD | Pharmacist |
| 5343 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509321600000",
"number": "1841580867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22549 W 72ND TER",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662272624",
"telephone_number": "952-913-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1664 BEDFORD LN",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553794449",
"telephone_number": "952-913-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "LARA",
"middle_name": "RAE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-11",
"last_updated": "2017-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5343",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shakopee, MN
- Alexander L Kayser
- Katherine Elizabeth Kearney-Bidwell, D.C.
- Jeffrey Donald Kendall, M.D.
- Herve Bertrand Kengne Mbakam, PHARMD, MS
- Elizabeth Maureen Kennedy Laliberte, PA-C
- Jacquelyn Lee Kerkow-Dohmen, LICSW
- Daniel N Kessler, PSY.D.
- Mohamed Hassan Khattab, M.D.
- Brayton Kiedrowski, D.O.
- Alexi Elizabeth Kimm
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.