Individual provider Active NPI

Kari Lee Kennedy, PSY.D., H.S.P.P.

  • Clinical Psychologist
  • Greenwood, IN
National Provider Identifier
1962501692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041821A Issued in IN
Practice address
420 E Main St
Greenwood, IN 46143-1364
Phone
(317) 807-0456
Fax
(866) 788-3791
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20041821A IN Primary

Addresses

Primary practice location

420 E Main St
Greenwood, IN 46143-1364

Mailing address

420 E Main St
Greenwood, IN 46143-1364
Phone (317) 807-0456

Other identifiers 1

IdentifierTypeStateIssuer
000000327281OtherINANTHEM INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20041821AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962501692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431364",
            "telephone_number": "317-807-0456",
            "fax_number": "866-788-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431364",
            "telephone_number": "317-807-0456",
            "fax_number": "866-788-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KARI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., H.S.P.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041821A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INSURANCE",
            "identifier": "000000327281",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.