DR. MARSHAL TERRANCE KENNEDY (NPI# 1639398845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639398845 |
| Entity Type | Individual |
| Full Name | DR. MARSHAL TERRANCE KENNEDY |
| Other Name | M TERRY KENNEDY |
| Credential | DPM |
| Practice Address |
2775 Se Powell Valley Rd Gresham OR 97080-1475 |
| Practice Telephone | 5036677789 |
| Practice Fax Number | 5036672032 |
| Mailing Telephone | 5036677789 |
| Mailing Fax Number | 5036672032 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | DP00139 | OR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 283523 | 05 |
| Street Address |
2775 SE POWELL VALLEY RD |
| City | GRESHAM |
| State | OR |
| Zip Code | 97080-1475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428554 | Jeffrey Henry Lucero | Social Worker | 4687 Se 1st Terrace, Gresham, OR 97080 | 2016-03-03 |
| 1124371059 | Nickole Turner | Massage Therapist | 2831 Se Palmquist Rd #157, Gresham, OR 97080 | 2012-10-16 |
| 1992061048 | Russell A Wendt | Pharmacist | 2497 Ne Roberts Ave, Gresham, OR 97080 | 2012-04-03 |
| 1821385584 | Angela West | Counselor | 320 Sw 6th Ave., Gresham, OR 97080 | 2011-07-01 |
| 1043543572 | Natalie Dawn Wilson | Behavioral Analyst | 97 Sw Riverview Place, Gresham, OR 97080 | 2009-09-16 |
| 1427205442 | Maria G Jolley | Dental Hygienist | 1267 Se Stapleton Loop, Gresham, OR 97080 | 2008-08-21 |
| 1073776738 | Sabrina Joye Hindman | Marriage & Family Therapist | 6370 Se 26th St, Gresham, OR 97080 | 2008-07-03 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1932223880 | Julie Elizabeth Croshaw | Pharmacist | 2444 E Powell Blvd, Gresham, OR 97080 | 2007-03-18 |
| 1508903261 | Lonetta Elise Davis | Adult Companion | 349 Se Plamblad, Gresham, OR 97080 | 2007-01-31 |
| Find all providers in zip 97080 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154869659 | Mid-columbia Medical Center | Podiatrist | 33 Nichols Pkwy, Hood River, OR 97031-3121 | 2017-02-03 |
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1689991804 | Cassandra Bree Tomczak | Podiatrist | 19250 Sw 65th Ave Ste 200, Tualatin, OR 97062 | 2010-04-27 |
| 1326363839 | Kessa Mauras | Podiatrist | 1100 E. Marina Way, Suite 223, Hood River, OR 97031 | 2010-03-29 |
| 1598907537 | Joshua Johnson Boone | Podiatrist | 551 Lone Prine Blvd, The Dalles, OR 97058 | 2009-04-06 |
| 1699928168 | Kristy R Six | Podiatrist | 400 Sw Bluff Dr Ste 220, Bend, OR 97702-1697 | 2008-10-28 |
| 1306093265 | Gilbert Alan Hice | Podiatrist | 953 Foots Creek Road, Gold Hill, OR 97525 | 2008-08-22 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| 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.