Edward Martin Kenney, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003088 Issued in NY

Practice address

97 Granger St
Canandaigua, NY 14424-1110

Phone

(585) 396-2643

NPI assigned

Jun 13, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1942243522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GRANGER ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 GRANGER ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241110",
            "telephone_number": "585-396-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "EDWARD",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01397153",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deloisa I Kelley, PMHNP
• Emmett J Kelliher
• Emilja Kelly, LPMHC
• Halie Kaitlyn Kemmling-Campbell, PA-C
• Dixie Gail Kendall, FNP
• Desire N Ketchandji, M.D.
• Yana Khashper, LCSW
• Dana Kincaid
• William J Kingston, MD
• Katherine Kjar

• Physician Assistant in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.