Jack H Kennady, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PG215532 Issued in OR

Practice address

849 Pacific Ave
Hood River, OR 97031-1956

Phone

(541) 386-6380

NPI assigned

Apr 5, 2023

Sex

Male

Sole proprietor

No

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 OR

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 Osteopathy

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1871298075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 PACIFIC AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311956",
            "telephone_number": "541-386-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNADY",
        "first_name": "JACK",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG215532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan M. Kealy, M.D.
• Conner Grace Keeffe
• Kellie Oosterbaan PSYD Rd PC
• Melanie Muirden Kelly, LCSW
• Jennifer Rose Kelson
• Jaleh Kermani
• Raelynn Keron, LMT
• Jaclyn Kerr, COTA/L
• Kevin Prates DDS, PC
• Kidsense Inc

• Student in an Organized Health Care Education/Training Program in Hood River, OR
• Providers in Hood River, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.