THE KENNEDY CLINIC PLLC NPI 1508078445

NPI Information

  • NPI: 1508078445
  • Provider Name: THE KENNEDY CLINIC PLLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 4957 SWINYAR DR STE 109
    OOLTEWAH, TN
    ZIP 37363
  • Phone: (423) 396-9893

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NPI Details

THE KENNEDY CLINIC PLLC is a primary care clinic center in Ooltewah, TN. THE KENNEDY CLINIC PLLC NPI is 1508078445. The provider is registered as an organization entity type.

The provider's business location address is:

4957 SWINYAR DR STE 109
OOLTEWAH, TN
ZIP 37363-205
Phone: (423) 396-9893
Fax: (423) 396-9508

The provider's authorized official is Howard Michael Kennedy .
The authorized official title is Managing Member and has the following contact phone number (423) 432-3130.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 9/12/2024.

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
1261QP2300XClinic/CenterPrimary CareYes

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
11942280052OTHERTENNESSEEKENNEDY NPI#
2413276426OTHERTENNESSEEKENNEDY SS#
34136940OTHERTENNESSEEKENNEDY BCBS

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: 3/30/2025

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