TOM KENNEY (NPI# 1710070057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710070057 |
| Entity Type | Individual |
| Full Name | TOM KENNEY |
| Practice Address |
1405 Eastland Dr Bloomington IL 61701-3514 |
| Practice Telephone | 3096612400 |
| Practice Fax Number | 3096616226 |
| Mailing Telephone | 3096612400 |
| Mailing Fax Number | 3096616226 |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2008-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036073299 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036073299 | 05 | |
| IL | MEDICARE GROUP NUMBER | 961850 | 01 |
| Street Address |
1405 EASTLAND DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396789210 | Kimberly Nord | Nurse Practitioner | 1405 Eastland Dr, Bloomington, IL 61701-3514 | 2006-06-15 |
| 1902349202 | Kimberly Shrode | Nurse Practitioner | 1405 Eastland Dr, Bloomington, IL 61701-3514 | 2016-11-18 |
| 1386951085 | Jessica M Sullivan | Nurse Practitioner | 1405 Eastland Dr, Bloomington, IL 61701-3514 | 2010-09-02 |
| 1619189859 | Lacie Shanks | Family Medicine | 1405 Eastland Dr, Bloomington, IL 61701-3514 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073165650 | Genevieve Elon Monge | Family Medicine | 18651 Valley Blvd, Bloomington, CA 92316-1831 | 2019-07-12 |
| 1982117172 | Andry Medical Services | Family Medicine | 451 S Park Ridge Rd Ste 101, Bloomington, IN 47401-8589 | 2017-11-09 |
| 1033459904 | Charles R Farmer | Family Medicine | 3480 S Oak Ridge Dr, Bloomington, IN 47401-8926 | 2013-02-28 |
| 1467798504 | James Anthony Ray | Family Medicine | 2001 E Hillside Dr Lot 4, Bloomington, IN 47401-6692 | 2012-12-18 |
| 1902140585 | Fountain Healthcare Limited Liability Company | Family Medicine | 2412 E Washington St Ste 6, Bloomington, IL 61704-4497 | 2012-11-20 |
| 1306147236 | Community Health Network | Family Medicine | 524 N Fairview St, Bloomington, IN 47404-3774 | 2010-11-09 |
| 1942501978 | Premier Medical Group, LLC | Family Medicine | 2102 E Washington St, Bloomington, IL 61701-4321 | 2010-11-08 |
| 1356660666 | Glen Edward Tomlinson | Family Medicine | 42 Crista Ann Ct, Bloomington, IL 61704-8699 | 2010-05-26 |
| 1285862664 | Charles W Mcclary | Family Medicine | 1411 S Sare Rd, Bloomington, IN 47401-4431 | 2009-06-24 |
| 1982840005 | Thomas Patterson Cairns | Family Medicine | 10258 Berkshire Rd, Bloomington, MN 55437-2265 | 2008-12-18 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.