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Individual provider Active NPI

David Robert Kennel, M.D.

  • Family Medicine Physician
  • Lakewood, WA
National Provider Identifier
1952345563
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00019823 Issued in WA
Practice address
5920 100TH St. SW
#31
Lakewood, WA 98499-0000
Phone
(253) 584-3023
Fax
(253) 582-1222
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00019823 WA Primary

Addresses

Primary practice location

5920 100TH St. SW
#31
Lakewood, WA 98499-0000

Mailing address

5920 100TH St. SW
#31
Lakewood, WA 98499-0000
Phone (253) 584-3023

Other identifiers 1

IdentifierTypeStateIssuer
1106046MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000619 WA Practitioner - Family Practice 1254380777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Physicians Medical Group, PLLCGroup PAC ID 3173796703, 4 clinicians

Practice addresses (Care Compare)

5920 100TH St SW
Suite 31
Lakewood, WA 98499-2751
Phone (253) 584-3023

Hospital & facility affiliations

  • Puget Sound Home Health Home health agency, Tacoma, WA, CCN 507101
  • Multicare Good Samaritan Home Health Home health agency, Tacoma, WA, CCN 507046
  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • Assured Home Health Home health agency, Mountlake Terrace, WA, CCN 507099
  • Centerwell Home Health Home health agency, Tacoma, WA, CCN 507031
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions12
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00019823WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physicians Medical Group, PLLC Family Medicine CurrentSince Aug 28, 2011 Accepting new patients

Locations

32124 1st Ave S
Ste 300
Federal Way, WA 98003
Phone (253) 941-0673

5920 100th St SW
Ste 31
Lakewood, WA 98499
Phone (253) 584-3023

5920 100th St SW
Ste 30
Lakewood, WA 98499
Phone (253) 584-1700

Organizations & group practices 1

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952345563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 100TH ST. SW",
            "address_2": "#31",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984990000",
            "telephone_number": "253-584-3023",
            "fax_number": "253-582-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 100TH ST. SW",
            "address_2": "#31",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984990000",
            "telephone_number": "253-584-3023",
            "fax_number": "253-582-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEL",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00019823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1106046",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.