Brian Robert Kennedy, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209011099 Issued in IL

Practice address

4102 Pinion Dr
Usaf Academy, CO 80840-2502

Phone

(719) 524-2273

NPI assigned

Jun 8, 2016

Sex

Male

Sole proprietor

Yes

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 IL, MO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Midwest Inpatient Anderson Health IncGroup PAC ID 3072908474, 46 clinicians

Meds Inpatient Services Associates, IncGroup PAC ID 1557865250, 14 clinicians

Midwest Emergency Centralia Campus Associates, Inc.Group PAC ID 2163672650, 15 clinicians

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians

Midwest Emergency Good Samaritan, IncGroup PAC ID 1658529342, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
• Washington County Hospital Hospital, Nashville, IL, CCN 141308

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Anderson Medical Group, LLC

  • General Practice Physician
  • Maryville, IL
  • NPI 1700807716
  Medicare reassignment Care Compare group NPD
• Meds Inpatient Services Associates, Inc

  • Hospitalist Physician
  • Centralia, IL
  • NPI 1154215895
  Medicare reassignment Care Compare group NPD
• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment Care Compare group NPD
• Midwest Emergency Centralia Campus Associates, Inc

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1396034245
  Medicare reassignment Care Compare group NPD
• Midwest Emergency Good Samaritan, Inc

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1629367578
  Medicare reassignment Care Compare group NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment Care Compare group NPD
• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment Care Compare group
• County of Clay

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  Medicare reassignment
• Central Illinois Radiological Associates, LTD.

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828
  NPD (past)

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation
• Washington County Hospital District

  • Rural Health Clinic/Center
  • Nashville, IL
  • NPI 1316555816

  Hospital

  Care Compare affiliation
• Washington County Hospital District

  • Critical Access Hospital
  • Nashville, IL
  • NPI 1659321560
  Care Compare affiliation

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1982053112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W SOUTHCREST CIR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253158",
            "telephone_number": "314-346-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-524-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Clayton Jackson, M.D.
• Shari Szucs Jacobson, ATC
• Brett Jessen
• Hillary Shea Johnson, PHARMD
• Kellie Ann Jones, DMD
• David A Kephart Jr., D.O.
• Stacy Keser
• Andrew Myungjean Kim, M.D.
• Steven L Klyn, DDS
• Dayton S Kobayashi, MD

• Family Nurse Practitioner in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.