MR. MICHAEL ARTHUR KENNEDY (NPI# 1245391473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245391473 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL ARTHUR KENNEDY |
| Credential | PA-C |
| Practice Address |
111 E Hwy 120 Ste. 104 Pottsboro TX 75076-3008 |
| Mailing Address |
1038 Addison Ave Pottsboro TX 75076-7077 |
| Practice Telephone | 9037863911 |
| Mailing Telephone | 9037868916 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA04828 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
| 1649346081 | Michael Dustin Kennedy | Family Medicine | 1645 North Main Street, Blacksburg, VA 24060 | 2006-11-28 |
| Street Address |
111 E HWY 120 STE. 104 |
| City | POTTSBORO |
| State | TX |
| Zip Code | 75076-3008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821615766 | Lauren Ashley Black | Pharmacist | 11205 N. Hwy 289, Pottsboro, TX 75076 | 2020-06-26 |
| 1700293453 | Lake Texoma Chiropractic | Chiropractor | 81750 N State Hwy 289 Ste 102, Pottsboro, TX 75076 | 2014-07-15 |
| 1750717948 | Deborah Lynn Burchfield | Nurse Practitioner | 81750 N State Hwy 289, Ste 101, Pottsboro, TX 75076 | 2013-09-19 |
| 1710227202 | Brookshire Grocery Company | Pharmacy | 11205 N Hwy 289, Pottsboro, TX 75076 | 2013-02-21 |
| 1275149692 | Steven Michael Fairchild | Pharmacist | 11205 N. Hwy 289, Pottsboro, TX 75076 | 2020-09-21 |
| 1750731493 | Rosa Villanueva | Physical Therapy Assistant | 190 Civic Cir, Suite 210, Lewisville, TX 75076 | 2016-06-14 |
| 1871929737 | Lake Texoma Health Clinic, Pllc | Clinic/Center | 81750 N State Hwy 289, Suite 101, Pottsboro, TX 75076 | 2013-09-23 |
| 1578659314 | Family Pharmacy of Pottsboro | Pharmacy | 111 Hiway 120e, Suite 101, Pottsboro, TX 75076-0000 | 2006-10-05 |
| 1194048819 | James Boothby Leblanc | Counselor | 105 Cardinal Lane, Pottsboro, TX 75076-0555 | 2010-03-09 |
| 1992272892 | Karen Ranee Bardwell | Social Worker | 108 S Magnolia St, Pottsboro, TX 75076-3058 | 2018-10-29 |
| Find all providers in zip 75076 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| 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.