MARTHA M. KENNON (NPI# 1144322827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144322827 |
| Entity Type | Individual |
| Full Name | MARTHA M. KENNON |
| Credential | PH.D. |
| Practice Address |
119 Boone Ridge Dr Suite 201 Johnson City TN 37615-4998 |
| Practice Telephone | 4232821480 |
| Mailing Telephone | 4232821480 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-05-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
293 | AL | Behavioral Health & Social Service Providers |
| Street Address |
119 BOONE RIDGE DR SUITE 201 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37615-4998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639161722 | Melissa Dawn Venoy | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2005-08-16 |
| 1083157788 | Amy Hamilton | Nurse Practitioner | 119 Boone Ridge Dr, Ste 201, Johnson City, TN 37615-8000 | 2016-11-29 |
| 1366992851 | Nikki Daniell Vaughn | Registered Nurse | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-10-07 |
| 1790230183 | Laura Casey | Registered Nurse | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-08-16 |
| 1104277656 | Ipc Pac Healthcare Services of Tennessee PC | Psychologist | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-06-27 |
| 1487008835 | Amanda Milan Smith | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-04-21 |
| 1083084560 | Hannah Audia | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-09-28 |
| 1033593223 | Carleen Marie Ogle | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-07-17 |
| 1104209675 | Lindsey Townsend Elswick | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-07-02 |
| 1811379639 | Stacey Hubbard | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1548692692 | Jason Lee Steadman | Psychologist | 1193 Jack Vest Dr, Behavioral Health and Wellness Clinic, Johnson City, TN 37614-6505 | 2013-07-31 |
| 1649345208 | Matthew David Johnson | Psychologist | 240 Riverside Dr Ste 2, Johnson City, NY 13790-2732 | 2006-11-21 |
| 1588670210 | Stephen L. Owens | Psychologist | 302 Sunset Dr Ste 106, Johnson City, TN 37604-2408 | 2006-08-01 |
| 1467476150 | Tedd A Stephens | Psychologist | 2112 N Roan St Fl 6, Johnson City, TN 37601-2519 | 2006-07-26 |
| 1790717411 | Nancy L Lanthorn | Psychologist | 704 E Watauga Ave, Johnson City, TN 37601-4112 | 2006-07-06 |
| 1811960644 | Kerry L. Holland | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2006-02-10 |
| 1760464937 | Heather L Beaudry | Psychologist | 1907 N Roan St Ste 207, Johnson City, TN 37601-3182 | 2005-11-15 |
| 1770197766 | Mary Ann Moore | Psychologist | 679 Main St, Johnson City, NY 13790-1716 | 2020-09-07 |
| 1184232605 | Bess Summerlin Lewis | Psychologist | Lamont St & Veterans Way, Johnson City, TN 37604 | 2020-07-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37615 |
Please comment or provide details below to improve the information on MARTHA M. KENNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.