TRACI KENNEDY (NPI# 1306206990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306206990 |
| Entity Type | Individual |
| Full Name | TRACI KENNEDY |
| Practice Address |
1300 Hospital Dr Ste 220 Mount Pleasant SC 29464-3208 |
| Practice Telephone | 8439366238 |
| Practice Fax Number | 8439366239 |
| Mailing Telephone | 8439366238 |
| Mailing Fax Number | 8439366239 |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2019-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
28091733A | IN | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 21498 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 71006563A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891130480 | Traci Michelle Kennedy | Psychologist | 3811 Ohara St, Pittsburgh, PA 15213-2561 | 2013-05-08 |
| Street Address |
1300 HOSPITAL DR STE 220 |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464-3208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972059004 | Jesse Perseghin | Chiropractor | 1300 Hospital Dr Ste 220, Mount Pleasant, SC 29464-3208 | 2016-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083229439 | Melissa Lynn Doering | Nurse Practitioner | 1054 Johnnie Dodds Blvd, Mount Pleasant, SC 29464-3153 | 2020-09-12 |
| 1851860332 | John Thomas Pattison V | Nurse Practitioner | 7070 E Broadway Rd, Mount Pleasant, MI 48858-8970 | 2018-11-14 |
| 1750806188 | Trista Ann Patten | Nurse Practitioner | 3811 Spring St # 301, Mount Pleasant, WI 53405-1667 | 2017-08-07 |
| 1841742152 | Emily Kastenson | Nurse Practitioner | 6611 Spring St, Mount Pleasant, WI 53406-2632 | 2016-11-03 |
| 1821349051 | Anna Rybak | Nurse Practitioner | 1604 Lakewood Ave, Mount Pleasant, WI 53403-3827 | 2012-09-27 |
| 1174630057 | Kimberly A Woyach | Nurse Practitioner | 8400 Washington Ave # 245, Mount Pleasant, WI 53406-3735 | 2006-08-24 |
| 1063010080 | Sara Ann Simpson | Nurse Practitioner | 6211 Durand Ave Ste 100, Mount Pleasant, WI 53406-4956 | 2020-10-12 |
| 1285242214 | Samantha Ashley Murray | Nurse Practitioner | 3801 Spring St, Mount Pleasant, WI 53405-1667 | 2020-07-15 |
| 1972136281 | Heather Marie Steppe | Nurse Practitioner | 3801 Spring St, Mount Pleasant, WI 53405-1667 | 2020-02-14 |
| 1831747625 | Sarantuya Nisler | Nurse Practitioner | 3805b Spring St Ste 260, Mount Pleasant, WI 53405-1643 | 2019-08-27 |
| Find all providers in MOUNT PLEASANT | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
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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.