Individual provider Active NPI

Kelly Kennedy, MD

  • Obstetrics & Gynecology Physician
  • Vero Beach, FL
National Provider Identifier
1992071377
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME160223 Issued in FL
Practice address
3745 11TH Cir Ste 101
Vero Beach, FL 32960-4838
Phone
(772) 567-6412
Fax
(321) 567-4991
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 65523 WI
Obstetrics & Gynecology Physician 207V00000X ME160223 FL Primary

Addresses

Primary practice location

3745 11TH Cir Ste 101
Vero Beach, FL 32960-4838

Mailing address

3745 11TH Cir Ste 101
Vero Beach, FL 32960-4838
Phone (772) 567-6412

Other practice location 1

5350 W. Hillsboro Blvd.
Ste 102
Coconut Creek, FL 33073-4396
Phone (954) 725-7660

Other identifiers 1

IdentifierTypeStateIssuer
100058166MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240319000859 FL Practitioner - Obstetrics/Gynecology 9436443025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

3745 11TH Cir
Suite 101
Vero Beach, FL 32960-4838
Phone (321) 452-3811

Hospital & facility affiliations

  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
  • Orlando Health Sebastian River Hospital Hospital, Sebastian, FL, CCN 100217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME160223FLMDObstetrics & Gynecology Physician
65523WIMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Obstetrics & Gynecology CurrentSince Mar 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2024 Accepting new patients
Dr. Chen OB/GYN P.a. Obstetrics & Gynecology CurrentSince Mar 1, 2023 Accepting new patients
Steward Medical Group, Inc. Obstetrics & Gynecology CurrentSince Apr 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Dr. Chen OB/GYN P.a. PastSince Mar 1, 2023 Accepting new patients
Stewart and Stewart a Medical Corporation Past Accepting new patients

Locations

5350 W Hillsboro Blvd
Ste 102
Coconut Creek, FL 33073
Phone (954) 725-7660

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

14430 US Highway 1
Ste 104
Sebastian, FL 32958
Phone (772) 589-6400

3745 11th Cir
Ste 101
Vero Beach, FL 32960
Phone (561) 299-3511

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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 2

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1992071377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 11TH CIR STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604838",
            "telephone_number": "772-567-6412",
            "fax_number": "321-567-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 11TH CIR STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604838",
            "telephone_number": "772-567-6412",
            "fax_number": "321-567-4991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5350 W. Hillsboro Blvd.",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Coconut Creek",
            "state": "FL",
            "postal_code": "330734396",
            "country_code": "US",
            "telephone_number": "954-725-7660",
            "fax_number": "954-725-7605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WI",
            "license": "65523",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME160223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100058166",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.