Roger Kennedy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C7069 Issued in OR

Practice address

1652 NW Hughwood CT
Roseburg, OR 97471-8844

Phone

(541) 673-3985

NPI assigned

Jul 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• 4 Badges Counseling LLC

  • Professional Counselor
  • Roseburg, OR
  • NPI 1003617218
  Medicare reassignment NPD Authorized official
• Valley View Mental Health Services, Inc

  • Professional Counselor
  • Roseburg, OR
  • NPI 1437297140
  Medicare reassignment NPD

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1891303152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 NW HUGHWOOD CT",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 NW HUGHWOOD CT",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718844",
            "telephone_number": "541-673-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ROGER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "Y",
            "affiliationName": "Valley View Mental Health Services, Inc",
            "address_1": "1652 NW Hughwood Ct",
            "city": "Roseburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974718844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kayla Ann Kelly, FNP-C
• Ky'an Kelly
• Francesca Ann Kenfield, QMHA
• Candice Hoke Kennedy, PH.D.
• Lexi Kennedy, CSWA
• Katie Jayne Benton Kenney, MSW
• Cynthia Dawn Kent
• Nathaniel Keplinger, DPM
• Pamela D Kerbo
• Deanna Elyse Kercher, RDH

• Professional Counselor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.
• 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.