DR. LISA SHEA KENNEDY M.D. NPI 1578570743

NPI Information

  • NPI: 1578570743
  • Provider Name: DR. LISA SHEA KENNEDY, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 403 E MEEKER ST STE 200
    KENT, WA
    ZIP 98030
  • Phone: (253) 852-2866

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NPI Details

DR. Lisa Shea Kennedy, M.D. is a family medicine in Kent, WA with 43 years of experience. The provider is 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. DR. Lisa Shea Kennedy, M.D. NPI is 1578570743. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY
Graduation Year:1983

The provider's business location address is:

403 E MEEKER ST STE 200
KENT, WA
ZIP 98030-904
Phone: (253) 852-2866
Fax: (253) 852-3102

The NPI 1578570743 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)

The enumeration date for this NPI number is 8/1/2006 and was last updated on 3/6/2025.

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
1207Q00000XFamily Medicine0101039112VIRGINIANo
2207Q00000XFamily MedicineMD60952683WASHINGTONYes

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
1320602OTHERVIRGINIAANTHEM HEALTHKEEPERS #
2320601OTHERVIRGINIAANTHEM PROVIDER #
34107755OTHERVIRGINIAAETNA PROVIDER #
45624959MEDICAIDVIRGINIA

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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