Anthony Braxton Kennedy, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-176649 Issued in AL

Practice address

126 Clinic Dr
Dothan, AL 36303-1980

Phone

(334) 793-1881

Fax

(334) 712-1815

NPI assigned

May 22, 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 AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dothan Pediatric Clinic, P. a.Group PAC ID 0749245330, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anthonykennedy@dpc.allscriptsdirect.net

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.

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788

  Family

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1922790773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-712-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-712-1815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 E Barbour St",
            "address_purpose": "LOCATION",
            "city": "Eufaula",
            "state": "AL",
            "postal_code": "360271603",
            "country_code": "US",
            "telephone_number": "334-619-0904",
            "fax_number": "334-689-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2125 W Roy Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "AL",
            "postal_code": "363608650",
            "country_code": "US",
            "telephone_number": "334-445-7337",
            "fax_number": "334-432-8001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5565 Montgomery Hwy",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363031552",
            "country_code": "US",
            "telephone_number": "334-699-3733",
            "fax_number": "334-500-3007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "526 Boll Weevil Cir",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "AL",
            "postal_code": "363304012",
            "country_code": "US",
            "telephone_number": "334-308-1166",
            "fax_number": "334-489-3002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ANTHONY",
        "middle_name": "BRAXTON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-176649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Hanna Kelly, R.N.
• Jane C Kelly, CRNA
• Lindsay Kelly, PHARMD
• Arthur C Kendig, MD
• Bryan T Kendricks, D.M.D., M.D.
• Christian Nicole Kennedy
• James A Kennedy, CRNA
• Savannah Kennedy
• Amy Kerecman, PTA
• Hassan Kesserwani, MD

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.