KENNETT RADIOLOGY ASSOCIATES NPI 1083878284

NPI Information

  • NPI: 1083878284
  • Provider Name: KENNETT RADIOLOGY ASSOCIATES
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 1301 1ST ST
    KENNETT, MO
    ZIP 63857
  • Phone: (573) 888-8424

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NPI Details

KENNETT RADIOLOGY ASSOCIATES is a diagnostic radiology radiology in Kennett, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. KENNETT RADIOLOGY ASSOCIATES NPI is 1083878284. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1301 1ST ST
KENNETT, MO
ZIP 63857-525
Phone: (573) 888-8424
Fax: (573) 888-2715

The provider's authorized official is Michelle Beacham .
The authorized official title is Controller and has the following contact phone number (573) 888-8424.

The enumeration date for this NPI number is 7/16/2008 and was last updated on 7/16/2008.

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
12085R0202XRadiologyDiagnostic RadiologyR2G95MISSOURIYes

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
1000015370MEDICARE PINMISSOURI
2500451901MEDICAIDMISSOURI

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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