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HEATHER AINE KENNEDY D.O. NPI 1821226499


NPI Information

NPI: 1821226499
Provider Name: HEATHER AINE KENNEDY, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1513 PARK AVE
COLUMBUS, WI
ZIP 53925
Phone: (920) 623-9611
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Heather Aine Kennedy, D.O. is a family medicine in Columbus, WI with 15 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. Heather Aine Kennedy, D.O. NPI is 1821226499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduation Year:2009

The provider's business location address is:

1513 PARK AVE
COLUMBUS, WI
ZIP 53925-618
Phone: (920) 623-9611
Fax: (920) 623-1788

The NPI 1821226499 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 6/23/2009 and was last updated on 11/30/2020.


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 Medicine58094-21WISCONSINYes

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
11821226499MEDICAIDWISCONSIN

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.