Kevin Conor Kenney, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

83604 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 526-2111

Fax

(715) 526-7308

NPI assigned

May 14, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkenney338202@direct.thedacare.org
• Direct secure messaging: kkenney705625@direct.hfhs.org

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.

• Thedacare Medical Center - Berlin, Inc.

  dba Community Health Network, Inc and Berlin Memorial Hospital

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  Medicare reassignment NPD
• Thedacare Medical Center - New London, Inc.

  • Critical Access Hospital
  • New London, WI
  • NPI 1538127220
  Medicare reassignment NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Medicare reassignment NPD
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1710333893
  Medicare reassignment NPD
• Thedacare Medical Center - Waupaca, Inc.

  • Emergency Medicine Physician
  • Waupaca, WI
  • NPI 1780782680
  Medicare reassignment NPD
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1902832306
  Medicare reassignment
• Richard S Veiga MD SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Waupaca, WI
  • NPI 1861434631
  NPD
• Thedacare Medical Center - Berlin, Inc.

  dba ThedaCare Remote Dispensing Site-Berlin

  • Community/Retail Pharmacy
  • Berlin, WI
  • NPI 1043072291
  NPD
• Thedacare Medical Center - New London, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • New London, WI
  • NPI 1639182926
  NPD
• Thedacare Medical Center - Shawano, Inc.

  dba ThedaCare Apothecary-Shawano

  • Community/Retail Pharmacy
  • Shawano, WI
  • NPI 1306516604
  NPD
• Thedacare Medical Center - Waupaca, Inc.

  dba ThedaCare Apothecary-Waupaca

  • Community/Retail Pharmacy
  • Waupaca, WI
  • NPI 1558031856
  NPD
• Thedacare Regional Medical Center - Appleton Inc.

  dba ThedaCare Apothecary - Oshkosh

  • Community/Retail Pharmacy
  • Oshkosh, WI
  • NPI 1215810346
  NPD

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1861014680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-7308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27351 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480713487",
            "country_code": "US",
            "telephone_number": "248-967-7795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "KEVIN",
        "middle_name": "CONOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "83604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke T Johnson, M.S., CCC-SLP
• Sonya M Jones, OT
• Lori Lea Kagerbauer, RPH
• Jenna Kristine Keller
• Elizabeth Kathleen Kelley, LPN/RCS
• Hannah Kerkhof, PA-C
• Lana Kern, RN
• McKenna J Kerscher, PA-C
• Emmy Kiecker, OTR
• Joshua Kilmer

• Emergency Medicine Physician in Shawano, WI
• Providers in Shawano, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.