DR. JAN ELIZABETH KENNEDY (NPI# 1235117508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235117508 |
| Entity Type | Individual |
| Full Name | DR. JAN ELIZABETH KENNEDY |
| Credential | PH.D. |
| Practice Address |
3551 Roger Brooke Dr Jbsa Ft Sam Houston TX 78234-4504 |
| Mailing Address |
15530 Elm Park St San Antonio TX 78247-2905 |
| Practice Telephone | 2109167014 |
| Practice Fax Number | 2109163494 |
| Mailing Telephone | 2103969366 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2020-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 24866 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730139098 | Jan Marie Kennedy | Nurse Practitioner | 1813 Beltline Rd Sw, Decatur, AL 35601-5506 | 2006-05-10 |
| 1912063736 | Jan L Kennedy | Social Worker | 164 W Main St, Suite A, New Market, MD 21774-6279 | 2006-12-28 |
| 1548265390 | Jan C Kennedy | Pathology | 2701 N Decatur Rd, Pathology Dept, Decatur, GA 30033-5918 | 2005-06-17 |
| Street Address |
3551 ROGER BROOKE DR |
| City | JBSA FT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616398 | Emily M Covais | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-10-09 |
| 1730793191 | George Brett Pulvermacher | Physical Therapist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-09-03 |
| 1053922559 | Aline Noelle Ulloa | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-08-10 |
| 1538778931 | Caroline Elizabeth Conner | Pharmacist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-31 |
| 1487263406 | Mary Michelle Ayres | Nurse Practitioner | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-27 |
| 1265040612 | Suzanne Elise Laux | Nurse Practitioner | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-21 |
| 1801414677 | James Martin Maloney | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-08 |
| 1861019473 | Jonathan Lee Custer | Nurse Anesthetist, Certified Registered | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-30 |
| 1528685336 | Erin Wheeler | Physical Therapist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-26 |
| 1821614322 | Ryan Hyatt | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375487 | Tara Austin | Clinical Neuropsychologist | 4900 Bagby Ave Apt 819, Waco, TX 76711-0035 | 2020-08-05 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1992330864 | Annelizabeth Robinson Carlew | Clinical Neuropsychologist | 6333 Forest Park Rd 1st Fl Bla.100, Dallas, TX 75390-5461 | 2020-03-11 |
| 1710511753 | Gulf Coast Neuropsychology, Pllc | Clinical Neuropsychologist | 1110 Nasa Pkwy Ste 108c, Houston, TX 77058-3351 | 2020-02-28 |
| 1356988372 | Jennifer Reynolds | Clinical Neuropsychologist | 8005 Canyon Parke Ct, Austin, TX 78726-4029 | 2019-12-09 |
| 1649835216 | Kaleidoscope Counseling and Assessment | Clinical Neuropsychologist | 1705 S Capital of Texas Hwy Ste 130, Austin, TX 78746-6587 | 2019-05-08 |
| 1104392067 | Neuropsychological Services of Texarkana Pllc | Clinical Neuropsychologist | 5411 Plaza Dr Ste E, Texarkana, TX 75503-1667 | 2018-10-18 |
| 1801370184 | Professional Exam Services Inc. | Clinical Neuropsychologist | 2233 E Grauwyler Rd Ste 107, Irving, TX 75061-3239 | 2018-09-21 |
| 1255815072 | Seema Pandya | Clinical Neuropsychologist | 9101 N Central Expy Ste 230, Dallas, TX 75231-6079 | 2018-09-18 |
| 1972097145 | Juliette Galindo | Clinical Neuropsychologist | 1333 Moursund Ave, Psychology/neuropsychology H124, Houston, TX 77030-3405 | 2018-06-20 |
| Find all providers with the same taxonomy | ||||
| City | JBSA FT SAM HOUSTON |
| Zip Code | 78234 |
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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.