MR. MICHAEL DEE KENNEDY (NPI# 1235386004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235386004 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL DEE KENNEDY |
| Credential | ARNP |
| Practice Address |
3120 Southride Lane Bonifay FL 32425 |
| Mailing Address |
3120 Southride Ln Bonifay FL 32425-3325 |
| Practice Telephone | 8505474440 |
| Practice Fax Number | 8505474441 |
| Mailing Telephone | 8505474440 |
| Mailing Fax Number | 8505474441 |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2017-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
ARNP9206905 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL LICENSE | ARNP9206905 | 01 |
| FL | 000636200 | 05 | |
| BCBS | Y129U | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992047427 | Michael W Kennedy | General Practice | 6686 Eagle Crossing Blvd, Brownsburg, IN 46112-7420 | 2013-03-22 |
| 1861732760 | Michael Kennedy | Social Worker | 865 Memorial Pkwy, Phillipsburg, NJ 08865-2730 | 2013-03-01 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1558507749 | Michael Patrick Kennedy | Registered Nurse | 11310 Huron St Ste 100, Northglenn, CO 80234-3090 | 2008-12-18 |
| 1861678435 | Michael George Kennedy | Social Worker | 1290 W 8th Pl, Suite A, Yuma, AZ 85364-3621 | 2008-01-14 |
| 1992985550 | Michael Arthur Kennedy | Preventive Medicine | 62 N. Chapel St, #100, Physicians Group, LLC, Newark, DE 19711-2238 | 2007-11-11 |
| 1639358088 | Michael John Kennedy | Chiropractor | 12105 41st Ave N, Apt 118, Plymouth, MN 55441-1200 | 2007-11-01 |
| 1588879043 | Michael Thomas Kennedy | Surgery | 28144 El Montanero, Laguna Niguel, CA 92677-7545 | 2007-05-10 |
| 1245361815 | Michael C Kennedy | Chiropractor | 3580 Rte 281, Cortland, NY 13045 | 2007-03-08 |
| 1245391473 | Michael Arthur Kennedy | Physician Assistant | 111 E Hwy 120, Ste. 104, Pottsboro, TX 75076-3008 | 2006-12-12 |
| Street Address |
3120 SOUTHRIDE LANE |
| City | BONIFAY |
| State | FL |
| Zip Code | 32425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558538868 | Patrick L Hawkins | Family Medicine | 3120 Southride Lane, Bonifay, FL 32425 | 2008-05-15 |
| 1346589629 | Jessica Register Ludwig | Nurse Practitioner | 3120 Southride Lane, Bonifay, FL 32425 | 2013-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124650270 | Elizabeth H Lolley | Counselor | 1987 Remington Pl, Bonifay, FL 32425 | 2020-02-06 |
| 1891333274 | Traci Corbin | Registered Nurse | 603 Scenic Hill Circle, Bonifay, FL 32425 | 2019-12-16 |
| 1912339565 | Cb Health Ventures, Inc. | Assisted Living Facility | 108 Wagner Rd., Bonifay, FL 32425 | 2013-08-06 |
| 1477763860 | Pak Rural Health | Internal Medicine | 812 S. Weeks St, Bonifay, FL 32425 | 2007-05-23 |
| 1073680245 | Ahmad Tariq Ismail | Family Medicine | 110 East Byrd Ave, Bonifay, FL 32425 | 2006-11-30 |
| 1982775805 | County of Holmes Office Clerk Board of County Commissioners | Ambulance | 949 E. Hwy 90, Bonifay, FL 32425 | 2006-11-13 |
| 1710080890 | Bonifay Nsg & Rehab | Assisted Living Facility | 304 N Brock Ave, Bonifay, FL 32425 | 2006-09-06 |
| 1710949318 | Florida Department of Health | Public Health or Welfare | 603 Scenic Circle, Bonifay, FL 32425 | 2006-04-06 |
| 1366431702 | Holmes County Hospital Corporation | General Acute Care Hospital | 2600 Hospital Drive, Bonifay, FL 32425 | 2005-10-18 |
| 1457353310 | Muhammad Amin | Surgery | 402 East Byrd Ave, Bonifay, FL 32425 | 2005-08-11 |
| Find all providers in zip 32425 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871724 | Brenna Schulman | Nurse Practitioner | 6859 Sw 18th St Ste 200, Boca Raton, FL 33433-7015 | 2020-11-04 |
| 1245831726 | Sydia Spence | Nurse Practitioner | 8001 Nw 66th Ter, Tamarac, FL 33321-7015 | 2020-11-02 |
| 1598365165 | Fernande Simeon | Nurse Practitioner | 6490 Nw 55th St, Coral Springs, FL 33067-2710 | 2020-10-31 |
| 1780284596 | Corrective Spinal Care Inc | Nurse Practitioner | 6965 Piazza Grande Ave Ste 207, Orlando, FL 32835-8780 | 2020-10-30 |
| 1023617420 | John Bertram Garrett Iv | Nurse Practitioner | 5079 Garrett Rd, Malone, FL 32445-3409 | 2020-10-19 |
| 1518565894 | Karen Giselle Reyes | Nurse Practitioner | 4563 Perth Rd, West Palm Beach, FL 33415-2811 | 2020-10-09 |
| 1265039424 | Catherine Dettelbach Lake | Nurse Practitioner | 3411 Shenandoah Dr W, Orange Park, FL 32073-6631 | 2020-10-01 |
| 1417562877 | Victoria Ann Jacobs | Nurse Practitioner | 3605 Lithia Ridge Blvd, Valrico, FL 33596-6482 | 2020-09-12 |
| 1760096135 | Conciergenp | Nurse Practitioner | 1221 S 23rd Ave, Hollywood, FL 33020-5912 | 2020-09-03 |
| 1649881434 | Dr Jose A Rivera LLC | Nurse Practitioner | 110 W Citrus St, Altamonte Springs, FL 32714-2502 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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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.