Raymond James Kennedy III, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

39653 Issued in MN

Practice address

2040 Woodwinds Dr
Woodbury, MN 55125-2522

Phone

(651) 259-9750

NPI assigned

Nov 21, 2005

Last updated

Jan 9, 2024By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Psychiatry

Education

Loyola University of Chicago, Stritch School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bachmann and Associates IncGroup PAC ID 0749271781, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bachmann and Associates, Inc. Dba Counseling Care

  dba Counseling Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Elmo, MN
  • NPI 1538158506
  Medicare reassignment Care Compare group NPD
• Aris Clinic PA

  dba Aris Clinic

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1609978063
  Medicare reassignment NPD
• St. Croix Psychiatric, LLC

  dba PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  Medicare reassignment NPD
• Aris Behavioral Health LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbury, MN
  • NPI 1083385231
  NPD
• Bachmann and Associates, Inc

  dba Counseling Care

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lake Elmo, MN
  • NPI 1144210899
  NPD
• County of Scott

  • Community/Behavioral Health Agency
  • Shakopee, MN
  • NPI 1710047535
  NPD (past)
• Psych Recovery Inc

  • Psychiatry Physician
  • Saint Paul, MN
  • NPI 1316189541
  NPD (past)
• Psychiatric Recovery PA

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1891713681
  NPD (past)
• Prairie St Johns

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1417901000
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1871576223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "RAYMOND",
        "middle_name": "JAMES",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "39653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038460700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1501790",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "991N7KE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula M Kelly, MD
• Wesley Kelly
• Janet Lynn Kelson, LMFT
• Alicia Marie Osterman Kemp, M.D.
• Mary J Kempf, CNM
• Shalene Ann Kennedy, MD
• Joshua M Kent, LICSW MSW
• Amy Elizabeth Kershaw, LPCC
• Erik Kersten, LPCC
• Jaime L Kessler, PHARMD

• Psychiatry Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.