MICHAEL SHAWN KENNEDY (NPI# 1306116066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306116066 |
| Entity Type | Individual |
| Full Name | MICHAEL SHAWN KENNEDY |
| Credential | SCHOOL PSYCHOLOGIST |
| Practice Address |
113 Hawk Dr Dulce NM 87528 |
| Mailing Address |
113 Hawks Dr Dulce NM 87528 |
| Practice Telephone | 5757593225 |
| Practice Fax Number | 5757593533 |
| Mailing Telephone | 5757593225 |
| Mailing Fax Number | 5757593533 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
344005 | NM | Behavioral Health & Social Service 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 |
| 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 |
| 1649346081 | Michael Dustin Kennedy | Family Medicine | 1645 North Main Street, Blacksburg, VA 24060 | 2006-11-28 |
| Street Address |
113 HAWK DR |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
| 1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
| 1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
| 1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
| 1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
| 1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
| 1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
| 1285823435 | Karen Keating | Counselor | 26 Narrow Gauge Dr., Dulce, NM 87528 | 2007-10-23 |
| Find all providers in zip 87528 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043340987 | Michael W Goldberg | Psychologist | 113 Hawk Drive, Dulce, NM 87528 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703701 | Cara Jean Burrola | Psychologist | 1111 Capitan St Nw, Los Lunas, NM 87031-6909 | 2020-09-08 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1548826829 | Stephanie Trujillo | Psychologist | 2810 N. Swan St., Silver City, NM 88061 | 2019-05-13 |
| 1003384181 | Patricia Keeler | Psychologist | # 50 County Rd. 13, Cuba, NM 87013 | 2018-11-07 |
| 1427562107 | Tascha Just | Psychologist | 1 Sunlit Dr E, Santa Fe, NM 87508-8993 | 2017-11-16 |
| 1164949780 | Christine S. Park | Psychologist | 6020 Constitution Ave Ne Ste 4, Albuquerque, NM 87110-5931 | 2017-08-24 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1477004281 | Ciarra Marrufo | Psychologist | 1100 W Bullock Ave, Artesia, NM 88210-2342 | 2016-10-17 |
| 1346697026 | Mary E. Sawyers, Ma, Lpcc | Psychologist | 1200 N White Sands Blvd Ste 118, Alamogordo, NM 88310-6774 | 2016-05-23 |
| 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.