Kelli A Kennedy, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

228253 Issued in MA

Practice address

51 Mill St, BLD E, Suite 17
HCS-Hanover Pediatrics
Hanover, MA 02339

Phone

(781) 826-2131

NPI assigned

Jul 10, 2006

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 MA

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellikennedy@hcs.allscriptsdirect.net

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.

• Healthcare South PC

  • Pediatrics Physician
  • Rockland, MA
  • NPI 1396726006
  Medicare reassignment NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1992739650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MILL ST",
            "address_2": "BLDG. E, #17",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391641",
            "telephone_number": "781-826-2131",
            "fax_number": "781-826-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MILL ST, BLD E, SUITE 17",
            "address_2": "HCS-HANOVER PEDIATRICS",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "02339",
            "telephone_number": "781-826-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELLI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "228253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Hamiltonlmhc, LTD
• Eileen Holmes Keenan, MSW, LICSW
• Erin Elizabeth Keenan, NP-C
• Dalissa Rubi Kelly, PHARMD
• Jessica Kennedy, M.ED.
• Nahid B Kennedy, D.O.
• Paul W Keough
• Keystone Healthcare Systems LLC
• Khanh Mendelowitz
• Laurie Kilgore, LICSW

• Pediatrics Physician in Hanover, MA
• Providers in Hanover, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.