MR. MICHAEL DEE KENNEDY ARNP NPI 1235386004

NPI Information

  • NPI: 1235386004
  • Provider Name: MR. MICHAEL DEE KENNEDY, ARNP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3120 SOUTHRIDE LANE
    BONIFAY, FL
    ZIP 32425
  • Phone: (850) 547-4440

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NPI Details

MR. Michael Dee Kennedy, ARNP is a primary care nurse practitioner in Bonifay, FL with 17 years of experience. MR. Michael Dee Kennedy, ARNP NPI is 1235386004. 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:

3120 SOUTHRIDE LANE
BONIFAY, FL
ZIP 32425
Phone: (850) 547-4440
Fax: (850) 547-4441

The NPI 1235386004 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/25/2008 and was last updated on 8/14/2024.

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
1363LP2300XNurse PractitionerPrimary CareARNP9206905FLORIDAYes

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
1ARNP9206905OTHERFLORIDAFL LICENSE
2000636200MEDICAIDFLORIDA
3Y129UOTHERBCBS

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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