MR. LARRY RAY KENNON APRN BC NPI 1003803370

NPI Information

  • NPI: 1003803370
  • Provider Name: MR. LARRY RAY KENNON, APRN, BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 1137 INDEPENDENCE DR
    WEST PLAINS, MO
    ZIP 65775
  • Phone: (417) 255-8464

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NPI Details

MR. Larry Ray Kennon, APRN, BC is a family nurse practitioner in West Plains, MO. MR. Larry Ray Kennon, APRN, BC NPI is 1003803370. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1137 INDEPENDENCE DR
WEST PLAINS, MO
ZIP 65775-221
Phone: (417) 255-8464

The enumeration date for this NPI number is 10/3/2005 and was last updated on 7/22/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily061052MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1528423MEDICARE UPIN
2428580211MEDICAIDMISSOURI
3261863OTHERMEDICARE FQHC
4812973700MEDICARE PIN
5000013700OTHERMEDICARE GROUP NUMBER
6261882OTHERMEDICARE FQHC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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