Active NPI
John W Kennedy, RPH
- Pharmacist
- Enid, OK
National Provider Identifier
1881977627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12527
- Practice address
- 929 W Owen K Garriott Rd
Enid, OK 73701-5439 - Phone
- (580) 237-3151
- Fax
- (580) 237-2564
- NPI assigned
- Sep 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12527 | OK | Primary |
Addresses
Primary practice location
929 W Owen K Garriott Rd
Enid, OK 73701-5439
Mailing address
505 South Jefferson
PO Box 475
Arnett, OK 73832
Phone (580) 216-2759
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12527 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1881977627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 SOUTH JEFFERSON",
"address_2": "PO BOX 475",
"city": "ARNETT",
"state": "OK",
"postal_code": "73832",
"telephone_number": "580-216-2759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 W OWEN K GARRIOTT RD",
"city": "ENID",
"state": "OK",
"postal_code": "737015439",
"telephone_number": "580-237-3151",
"fax_number": "580-237-2564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JOHN",
"middle_name": "W",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-27",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "12527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.