DR. SAMANTHA FUGATE KENNEDY


Address: 909 Fee Rd Ste B119, East Lansing, MI 48824
Phone: 5173533070

DR. SAMANTHA FUGATE KENNEDY (NPI# 1154760312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154760312
Entity Type Individual
Full Name DR. SAMANTHA FUGATE KENNEDY
Other Name SAMANTHA ANN FUGATE
Credential D.O.
Practice Address 909 Fee Rd Ste B119
East Lansing
MI 48824
Mailing Address 804 Service Rd
# A109f
East Lansing
MI 48824-7015
Practice Telephone 5173533070
Practice Fax Number 5174323603
Mailing Telephone 5178842976
Mailing Fax Number 5174323928
Enumeration Date 2013-06-21
Last Update Date 2018-06-25
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
5101020751 MI Allopathic & Osteopathic Physicians

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Office Location

Street Address 909 FEE RD STE B119
City EAST LANSING
State MI
Zip Code 48824

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528680303 Emilia Elizabeth Mattioli Psychiatry & Neurology 965 Fee Road Room A223, East Lansing, MI 48824 2020-05-14
1447871983 James O'brien Psychiatry & Neurology Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 2020-05-06
1750916979 Mulin Xiong Student in an Organized Health Care Education/Training Program 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 2020-03-09
1821659301 Tovah Apolonia Aho Psychiatry & Neurology Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 2019-06-25
1912564881 Asmara Theresa Hoo Psychiatry & Neurology 965 Fee Road, Room A233, East Lansing, MI 48824 2019-05-24
1790276822 Traverse Health Clinic and Coalition Clinic/Center East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 2018-05-24
1922598515 Jubin Joseph Cheruvelil Specialist/Technologist, Other 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 2018-05-18
1073003257 Dawn Arvye Contreras Health Educator 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 2018-05-14
1710406046 Kimberly Ann Breukink Social Worker 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 2017-09-19
1043766314 Ahmed Jouan Psychiatry & Neurology 804 Service Rd A217, East Lansing, MI 48824 2016-08-28
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629416169 Shady S Shebak Psychiatry & Neurology 965 Fee Rd, Room A233 East Fee Hall, East Lansing, MI 48824-6410 2013-06-06
1902981103 Leslie Greene Macauley Psychiatry & Neurology 4970 Northwind Dr, East Lansing, MI 48823-5080 2006-10-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316376056 Esmaeil Emami Psychiatry & Neurology 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 2013-11-04
1407199961 David Donald Krohn Psychiatry & Neurology 563 Highland Park Dr, Traverse City, MI 49686-2863 2013-04-03
1164712055 Tatjana Maric Psychiatry & Neurology 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 2011-04-12
1972893824 Katherine Barbara Krive Psychiatry & Neurology 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 2011-04-12
1104128602 Hope Network Behavioral Health Services Psychiatry & Neurology 3361 36th Street, Grand Rapids, MI 49512 2010-12-03
1295056653 Veronica Yap Tan Psychiatry & Neurology 23354 Portage Way, Apt. 2212, Novi, MI 48375 2010-06-18
1548588874 Katie Alanna Keller Psychiatry & Neurology 79 Alexandrine West, Detroit, MI 48201 2010-05-11
1538390133 Behavioral Health Associates Pllc Psychiatry & Neurology 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 2009-07-30
1235375775 Kristine Baker Psychiatry & Neurology 721 Cherokee St, Traverse City, MI 49684-1401 2009-01-06
1689820078 Margaret Mary Casey Psychiatry & Neurology 1326 Saint Antoine St, Detroit, MI 48226-2301 2008-08-18
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Competitor

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City EAST LANSING
Zip Code 48824

Improve Information

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Dataset Information

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.

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