DR. ROBERT MICHAEL KENNEDY (NPI# 1043219694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043219694 |
| Entity Type | Individual |
| Full Name | DR. ROBERT MICHAEL KENNEDY |
| Credential | M.D. |
| Practice Address |
777 Hospital Way G15 Pocatello ID 83201-5175 |
| Practice Telephone | 2082392722 |
| Practice Fax Number | 2082393759 |
| Mailing Telephone | 2082392722 |
| Mailing Fax Number | 2082393759 |
| Enumeration Date | 2005-07-16 |
| Last Update Date | 2013-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
M4241 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893098 | Robert Dale Kennedy | Technician | 460 Mitchell Branch, Red Jacket, WV 25692 | 2020-08-26 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1588119481 | Robert Kennedy | Counselor | 313 W Valencia St, Lakeland, FL 33805-3138 | 2016-08-20 |
| 1538549514 | Robert Kennedy | Physical Therapy Assistant | 300 Seville Road, Hurricane, WV 25526 | 2015-06-04 |
| 1780096040 | Robert Kennedy IIi | Social Worker | 654 Jones Ln, Dublin, GA 31021-0303 | 2014-05-21 |
| 1134492481 | Robert S Kennedy | Pharmacist | 3551 Roger Brooke Dr # Drive, Jbsa Ft Sam Houston, TX 78234-4504 | 2012-02-17 |
| 1215163142 | Robert Edward Kennedy | Psychoanalyst | 50 Greenwood Ave, Jersey City, NJ 07306 | 2009-06-05 |
| 1134379415 | Robert Joseph Kennedy | Physical Therapist | 155 Bryant Ave, Glen Ellyn, IL 60137-5523 | 2008-09-24 |
| 1063691889 | Robert Leslie Kennedy | Pharmacist | 1735 Scherm Rd, Owensboro, KY 42301-5972 | 2007-10-29 |
| 1578635926 | Robert M Kennedy | Dentist | 200 The Great Road, Suite 243, Bedford, MA 01730 | 2006-11-14 |
| Street Address |
777 HOSPITAL WAY G15 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1437612447 | Walter S Medlin Md PC | Surgery | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-04-08 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578667739 | Mary Elizabeth Gerard | Psychiatry & Neurology | 333 N 18th Ave Ste B4, Pocatello, ID 83201 | 2006-09-11 |
| 1265670061 | M Elizabeth Gerard Md Pllc | Psychiatry & Neurology | 333 N 18th Ave, Ste B4, Pocatello, ID 83201 | 2009-02-02 |
| 1881754901 | Scott S Petty | Psychiatry & Neurology | 1777 E Clark St, Suite 330, Pocatello, ID 83201-3357 | 2006-12-11 |
| 1700807260 | Richard D Karem | Psychiatry & Neurology | 777 Hospital Way, Pocatello, ID 83201-5175 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508286188 | Nina Sienna Bozinov | Psychiatry & Neurology | 700 W Ironwood Dr Ste 158, Coeur D Alene, ID 83814-4404 | 2014-04-22 |
| 1922449453 | Sarita Said Said | Psychiatry & Neurology | 2400 W A St, Moscow, ID 83843-4902 | 2013-07-12 |
| 1386903359 | Daniel B Simmons | Psychiatry & Neurology | 1072 N Liberty St Ste 303, Boise, ID 83704 | 2012-05-11 |
| 1053678342 | Daniel Clark Abenroth | Psychiatry & Neurology | 9th Floor -- Neurosciences, 190 E Bannock St., Boise, ID 83712-8905 | 2012-04-12 |
| 1427294545 | Thomas E Henson | Psychiatry & Neurology | 3183 S Temperance Way, Boise, ID 83706-5703 | 2008-12-18 |
| 1235381948 | Karin Lindholm, D.o. | Psychiatry & Neurology | 901 N Curtis Rd Ste 403, Boise, ID 83706-1342 | 2008-10-14 |
| 1548452683 | Sergei V Kashirny | Psychiatry & Neurology | 125 E Idaho St Ste 300, Neurology, Boise, ID 83712-6256 | 2007-08-13 |
| 1316090426 | Affiliated Neurologists Pllc | Psychiatry & Neurology | 338 6th St, Suite 102, Lewiston, ID 83501-2419 | 2007-01-19 |
| 1437252723 | Eastern Idaho Neurological Associates Pa | Psychiatry & Neurology | 2353 Coronado Drive, Idaho Falls, ID 83404 | 2006-09-05 |
| 1043249964 | Martha A Cline | Psychiatry & Neurology | 3875 E Overland Road, Meridian, ID 83642 | 2006-07-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.