KENNETH C KAVANAGH ARNP NPI 1699825919

NPI Information

NPI: 1699825919
Provider Name: KENNETH C KAVANAGH, ARNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: COMMUNITY SERVICES INSTITUTE, INC.

PECOS Registration: Yes

Address:
780 ALBANY ST
BOSTON, MA
ZIP 02118
Phone: (857) 654-1600
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Kenneth C Kavanagh, ARNP is a psychiatric/mental health nurse practitioner in Boston, MA with 28 years of experience. Kenneth C Kavanagh, ARNP NPI is 1699825919. 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:

780 ALBANY ST
BOSTON, MA
ZIP 02118-524
Phone: (857) 654-1600

The NPI 1699825919 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 1/11/2007 and was last updated on 12/12/2012.

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
1	363L00000X	Nurse Practitioner		ARNP9200934	FLORIDA	No
2	363LA2200X	Nurse Practitioner	Adult Health	ARNP9200934	FLORIDA	No
3	363LA2200X	Nurse Practitioner	Adult Health	213555	MASSACHUSETTS	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	213555	MASSACHUSETTS	Yes

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
1	U1009W	MEDICARE PIN	FLORIDA
2	P28204	MEDICARE UPIN	FLORIDA
3	Y124U	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD
4	305613900	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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