Howard Michael Kennedy Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

408 Issued in TN

Practice address

4957 Swinyar Dr Ste 109
Ooltewah, TN 37363-2205

Phone

(423) 432-3130

Fax

(423) 396-9508

NPI assigned

Jan 17, 2006

Last updated

Jan 26, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• The Kennedy Clinic PLLC

  • Primary Care Clinic/Center
  • Ooltewah, TN
  • NPI 1508078445
  Medicare reassignment Authorized official
• DX Mso, PLLC

  dba Doctors Express

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment
• Battlefield Orthopedics PC

  dba The Orthopedic Specialists

  • Orthopaedic Surgery Physician
  • Chattanooga, TN
  • NPI 1275573909
  NPD (past)
• Covenant Medcare LLC

  • Internal Medicine Physician
  • Dunlap, TN
  • NPI 1144428780
  NPD (past)
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Chattanooga, TN
  • NPI 1437194222
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1942280052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 109",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-432-3130",
            "fax_number": "423-396-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 109",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-432-3130",
            "fax_number": "423-396-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "HOWARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "408",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36660801",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K-VA-T Food Stores Inc (Food City Pharmacy #774)
• Aaron Keiser, DDS
• Jordan David Keller, LPC-MHSP
• Melissa G Kelley, PTA
• Darlene Kellogg, CNA
• Janine Marie Kennedy, PA-C
• Kidney Center of Ooltewah- Collegedale LLC
• Eli Yong Kim, M.D.
• Amanda Kirkpatrick, RD, LDN
• Mark David Kirshner, C.PED, CO

• Physician Assistant in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.