Active NPI
Molly A Kennedy, AUD
- Audiologist
- Gallipolis, OH
National Provider Identifier
1851838189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A.02050
- Practice address
- 100 Jackson Pike
Gallipolis, OH 45631-1560 - Phone
- (740) 446-5415
- Fax
- (740) 446-5958
- NPI assigned
- Jan 25, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | A.02050 | OH | Primary |
Addresses
Primary practice location
100 Jackson Pike
Gallipolis, OH 45631-1560
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5415
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851838189 | Medicaid | WV | |
| 0203082 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A.02050 | OH | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494201600000",
"number": "1851838189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5415",
"fax_number": "740-446-5958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5415",
"fax_number": "740-446-5958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MOLLY",
"middle_name": "A",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2017-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OH",
"license": "A.02050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851838189",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0203082",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.