Individual provider Active NPI

Brian Craig Kennedy, PA-C, MPAS

  • Physician Assistant
  • Concord, NH
National Provider Identifier
1851892269
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1329 Issued in NH
Practice address
8 Loudon Rd
Concord, NH 03301-5300
Phone
(603) 226-9000
NPI assigned
Feb 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1329 NH Primary

Addresses

Primary practice location

8 Loudon Rd
Concord, NH 03301-5300

Mailing address

8 Loudon Rd
Concord, NH 03301-5300
Phone (603) 226-9000

Other identifiers 1

IdentifierTypeStateIssuer
1329OtherNHNH PHYSICIAN ASSISTANT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409002198 NH Practitioner - Physician Assistant 7214290022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

25 Leavey Dr
Bedford, NH 03110-4437
Phone (603) 663-3740

40 Butrrick Rd
Londonderry, NH 03053-3381

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1329NHMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1851892269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LOUDON RD",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015300",
            "telephone_number": "603-226-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LOUDON RD",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015300",
            "telephone_number": "603-226-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRIAN",
        "middle_name": "CRAIG",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH PHYSICIAN ASSISTANT LICENSE",
            "identifier": "1329",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.