JOHN WAYNE KENNEDY MD NPI 1780665448

NPI Information

  • NPI: 1780665448
  • Provider Name: JOHN WAYNE KENNEDY, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1614 N BALDWIN AVE
    MARION, IN
    ZIP 46952
  • Phone: (765) 664-9000

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NPI Details

John Wayne Kennedy, MD is a general practice in Marion, IN. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee John Wayne Kennedy, MD NPI is 1780665448. 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:

1614 N BALDWIN AVE
MARION, IN
ZIP 46952-437
Phone: (765) 664-9000
Fax: (765) 391-1521

The NPI 1780665448 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 11/9/2005 and was last updated on 2/15/2013.

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
1207Q00000XFamily Medicine01022780INDIANANo
2208D00000XGeneral Practice01022780AINDIANAYes

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
1000000286588OTHERINDIANAANTHEM BCBS
2000000697935OTHERINDIANABCBS
3100123680MEDICAIDINDIANA
4M400039735MEDICARE PININDIANA
5000000576122OTHERINDIANABCBS
6C24781MEDICARE UPIN

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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