Jay Pehrson Kennedy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22442 Issued in NE

Practice address

2200 SW Gage Boulevard
U.S. Department of Veterans Affairs
Topeka, KS 66622-0000

Phone

(785) 350-3111

Fax

(785) 350-4496

NPI assigned

Jul 27, 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

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1962416909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SW GAGE BOULEVARD",
            "address_2": "U.S. DEPARTMENT OF VETERANS AFFAIRS",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666220000",
            "telephone_number": "785-350-3111",
            "fax_number": "785-350-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SW GAGE BOULEVARD",
            "address_2": "U.S. DEPARTMENT OF VETERANS AFFAIRS",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666220000",
            "telephone_number": "785-350-3111",
            "fax_number": "785-350-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JAY",
        "middle_name": "PEHRSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Kemper, LMSW
• Robert S Kenagy, MD
• Jamie Kendrick, COTA
• Lyda Carol Kendrick, MA, CCC-SLP
• Dawn J Kennedy, PTA
• Jessa Kennedy, NP
• Leah H Kennedy
• Melissa Joy Kennedy
• Michael Patrick Kennedy, APRN
• Quinn Kennedy

• Family Medicine Physician in Topeka, KS
• Providers in Topeka, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.