DEREK MICHAEL KENNEDY (NPI# 1316548704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316548704 |
| Entity Type | Individual |
| Full Name | DEREK MICHAEL KENNEDY |
| Credential | BA |
| Practice Address |
250 20th Ave N Clinton IA 52732-2503 |
| Practice Telephone | 5632432124 |
| Mailing Telephone | 5632432124 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821486622 | Derek Kennedy | Counselor | 177 E 122nd St, New York, NY 10035-2906 | 2014-12-31 |
| 1396088571 | Derek B Kennedy | Emergency Medicine | 207 Foote Ave, Jamestown, NY 14701 | 2013-04-05 |
| Street Address |
250 20TH AVE N |
| City | CLINTON |
| State | IA |
| Zip Code | 52732-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194361758 | Kelly Jean Saul | Counselor | 250 20th Ave N, Clinton, IA 52732-2503 | 2019-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343240 | Janet R Graf | Technician | 450 South 19th St., Clinton, IA 52732 | 2019-08-29 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1821528423 | Tricia Lee Grimes | Technician | 2349 Dunham St, Clinton, IA 52732 | 2017-06-15 |
| 1750822425 | Danielle Judd | Skilled Nursing Facility | 2220 N 5th St, Clinton, IA 52732 | 2017-03-15 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1275829921 | Rebecca Plante | Pharmacist | 1309 N 2nd Street, Clinton, IA 52732 | 2011-06-21 |
| 1639318363 | Ryan P Connell | Chiropractor | 1437 Main Ave, Clinton, IA 52732 | 2009-02-19 |
| Find all providers in zip 52732 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383453 | Sabrina Schotte Cook | Counselor | 10126 N Us Highway 421, Clinton, NC 28328-0271 | 2020-10-15 |
| 1194361758 | Kelly Jean Saul | Counselor | 250 20th Ave N, Clinton, IA 52732-2503 | 2019-11-19 |
| 1649757055 | Susan Wolever | Counselor | 2727 S 19th St, Clinton, IA 52732-7010 | 2018-07-27 |
| 1750868162 | Jill Ann Nothdorf-gisel | Counselor | 250 20th Ave N Ste 250, Clinton, IA 52732-2506 | 2018-07-27 |
| 1326492554 | Jeffrey Marcus Hunt | Counselor | 65 Old Route 22, Suite 7b, Clinton, NJ 08809-0000 | 2016-04-13 |
| 1356742027 | Robert C. Hardin Sr. | Counselor | 12705 Piscataway Landing Dr, Clinton, MD 20735-6503 | 2014-09-11 |
| 1952651804 | Alberto Varela | Counselor | 1407 N 2000 W Ste A, Clinton, UT 84015-8563 | 2012-09-18 |
| 1497018287 | Melanie N Benson | Counselor | 80 N 31st St, Clinton, OK 73601-9116 | 2012-06-18 |
| 1437422755 | Anzetta Nekol Pyles | Counselor | 321 Summeral St, Clinton, SC 29325-3649 | 2012-02-16 |
| 1891981460 | Erin Lee White-fish | Counselor | 1150 Route 54 W, Clinton, IL 61727-2148 | 2007-09-18 |
| Find all providers in CLINTON | ||||
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| 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.