Laura Cancilla Kenny, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35-086281 Issued in OH

Practice address

1515 Cavalry Dr.
Ste 102
Florence, KY 41042

Phone

(859) 817-9772

Fax

(859) 817-9885

NPI assigned

Apr 26, 2006

Last updated

Mar 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Brightview, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1659769446
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Ohio-Columbus II Professional Corp

  • Internal Medicine Physician
  • Chillicothe, OH
  • NPI 1861038069
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Ohio, Professional Corporation

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1043572290
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Richland County, LTD

  • Internal Medicine Physician
  • Canton, OH
  • NPI 1639119027
  Medicare reassignment NPD
• Brightview LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Asheboro, NC
  • NPI 1962163782
  NPD
• Strong Medical Group

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1184664948

  Internal Medicine

  NPD (past)
• University Internal Medicine Associates, Inc.

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1588620850
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1881650885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 CAVALRY DR.",
            "address_2": "STE 102",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-817-9772",
            "fax_number": "859-817-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CAVALRY DR.",
            "address_2": "STE 102",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-817-9772",
            "fax_number": "859-817-9885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "OH",
            "postal_code": "451031920",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "599 Freedom Park Dr",
            "address_purpose": "LOCATION",
            "city": "Crestview Hills",
            "state": "KY",
            "postal_code": "410175130",
            "country_code": "US",
            "telephone_number": "859-331-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1154A Lexington Rd",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403249330",
            "country_code": "US",
            "telephone_number": "502-868-7272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2645 N Laurel Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "London",
            "state": "KY",
            "postal_code": "407419075",
            "country_code": "US",
            "telephone_number": "502-749-6249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9702 Stonestreet Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402726812",
            "country_code": "US",
            "telephone_number": "502-749-6249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "LAURA",
        "middle_name": "CANCILLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-086281",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "KY",
            "license": "43946",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.086281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6410106600",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00224928",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200523050",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2594581",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Dietz Kennedy, ARNP
• Wendy Kennedy
• Charles Edwin Kenner, D.M.D
• Katherine Elizabeth Kenner, BCBA
• Kenneth F. Wallace
• Kentucky CVS Pharmacy LLC (CVS Pharmacy #16557)
• Kentucky CVS Pharmacy, L.L.C. (CVS Pharmacy# 07648)
• Kentucky Easter Seal Society Inc (Cardinal Hill of Northern Kentucky)
• Claire Victoria Keyes, FNP
• Magued Nadim Khouzam, M.D.

• Internal Medicine Physician in Florence, KY
• Providers in Florence, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.