Jessica Rene' Kennedy

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

87596 Issued in OK

Practice address

509 E Highway 33
Perkins, OK 74059-4129

Phone

(405) 547-2473

Fax

(405) 547-2925

NPI assigned

Apr 5, 2019

Last updated

Jul 8, 2026By the provider in NPPES

Sex

Female

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 OK

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.kennedy.p1@direct.smc.nextgenshare.com

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.

• Stillwater Medical Center Authority

  • Family Medicine Physician
  • Stillwater, OK
  • NPI 1558377135
  Medicare reassignment NPD
• Stillwater Medical Center Authority

  dba Stillwater Family Medical of Perry

  • Family Medicine Physician
  • Perry, OK
  • NPI 1407729361
  NPD
• Stillwater Medical Center Authority

  dba Stillwater Medical Center

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  NPD (past)
• Stillwater Medical Center Physicians

  • Anesthesiology Physician
  • Stillwater, OK
  • NPI 1295859387
  NPD (past)

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1952863078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "PERKINS",
            "state": "OK",
            "postal_code": "740590460",
            "telephone_number": "405-547-2473",
            "fax_number": "405-547-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E HIGHWAY 33",
            "city": "PERKINS",
            "state": "OK",
            "postal_code": "740594129",
            "telephone_number": "405-547-2473",
            "fax_number": "405-547-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JESSICA",
        "middle_name": "RENE'",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "87596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iowa Tribe of Oklahoma (Bah-Kho-Je Dental)
• Iowa Tribe of Oklahoma (Perkins Family Clinic Pharmacy)
• Iowa Tribe of Oklahoma (Bah-Kho-Je Medical Center)
• Jamie Rae Johnson, REGISTERED NURSE
• Joshua R Johnson
• Amatula Khabir
• Justin Kimmel
• Sarah Kyle, CLD, CLSE
• William Russell Lane, DC
• Lynda Leach

• Pediatric Nurse Practitioner in Perkins, OK
• Providers in Perkins, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.