Provider Type Icon

DR. JASIRI KENNEDY M.D. NPI 1972583185


NPI Information

NPI: 1972583185
Provider Name: DR. JASIRI KENNEDY, M.D.
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual
Organization: ALTAMONT EMERGENCY PHYSICIANS MEDICAL GROUP INC

PECOS Registration: Yes

Address:
1325 BROADWAY ST
ROCKPORT, TX
ZIP 78382
Phone: (361) 729-0646
Get Directions

DR. Jasiri Kennedy, M.D. is an emergency medicine in Rockport, TX with 28 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Jasiri Kennedy, M.D. NPI is 1972583185. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduation Year:1996

The provider's business location address is:

1325 BROADWAY ST
ROCKPORT, TX
ZIP 78382-333
Phone: (361) 729-0646
Fax: (361) 729-8854

The NPI 1972583185 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 1/23/2006 and was last updated on 12/19/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineL4016TEXASNo
2207Q00000XFamily MedicineL4016TEXASNo
3207P00000XEmergency Medicine036-098701ILLINOISNo
4207P00000XEmergency MedicineA81294CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036098701MEDICAIDILLINOIS
2214881005MEDICARE PINILLINOIS
300A812940MEDICAIDCALIFORNIA
400A812941MEDICARE PIN
53932056OTHERILLINOISBLUE SHIELD
6H59047MEDICARE UPINTEXAS
700A812940MEDICARE PINCALIFORNIA

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

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.