TIMOTHY J KENNEDY (NPI# 1417985631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417985631 |
| Entity Type | Individual |
| Full Name | TIMOTHY J KENNEDY |
| Credential | MD |
| Practice Address |
2845 Greenbrier Rd Ste 240 Green Bay WI 54311-6519 |
| Mailing Address |
2845 Greenbrier Rd Ste 240 Po Box 8900 Green Bay WI 54308-8900 |
| Practice Telephone | 9202888280 |
| Practice Fax Number | 9202888285 |
| Mailing Telephone | 9202888280 |
| Mailing Fax Number | 9202888285 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 29987 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 104386153 | 05 | |
| WI | RAILROAD | 340015995 | 01 |
| MI | BCBS | 3402100592 | 01 |
| MI | 104386126 | 05 | |
| WI | 31501900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962856732 | Timothy Kennedy | Internal Medicine | 6701 Airprot Blvd, Ste A101, Mobile, AL 36608-0000 | 2016-04-19 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| 1568433720 | Timothy J Kennedy | Chiropractor | 1712 15th Street Pl, Moline, IL 61265-3961 | 2006-01-27 |
| 1043587751 | Timothy Kennedy | Specialist/Technologist | 4225 Genesee St, Cheektowaga, NY 14225-1994 | 2011-11-23 |
| 1346406238 | Timothy Martin Kennedy | Occupational Therapist | 25 Chateau Ter, Amherst, NY 14226-3927 | 2008-07-31 |
| 1235394255 | Timothy John Kennedy | Surgery | 195 Little Albany St, Suite 560, New Brunswick, NJ 08901-1914 | 2008-07-21 |
| 1790830610 | Timothy Alan Kennedy | Social Worker | 6827 N High St, 121, Worthington, OH 43085-2517 | 2007-01-23 |
| 1891885869 | Timothy B Kennedy | Psychiatry & Neurology | 3188 Atlanta Road, Smyrna, GA 30080 | 2006-10-13 |
| 1356398283 | Timothy C Kennedy | Internal Medicine | 1601 E 19th Ave, 6250, Denver, CO 80218-1216 | 2006-05-27 |
| 1720033319 | Timothy Robert Kennedy | Obstetrics & Gynecology | 1780 Nw Myhre Rd, Suite 2120, Silverdale, WA 98383-8676 | 2006-05-23 |
| Street Address |
2845 GREENBRIER RD STE 240 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-6519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740226265 | Myron M Marlett | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2006-06-22 |
| 1780969246 | Ethan A Karol | Physician Assistant | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2011-10-17 |
| 1316117500 | Stephanie R Smullen | Physician Assistant | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2008-03-04 |
| 1013139641 | Heather M Stefaniak | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2007-05-03 |
| 1639196413 | Arthur M Sonneland IIi | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2006-07-16 |
| 1548298789 | William Scott Dougherty | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2006-06-28 |
| 1154359388 | Bruce M Neal | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
| 1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| Find all providers in zip 54311 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710293105 | Charles Copland Smith | Urology | 674 Sunset Circle, Green Bay, WI 54301 | 2010-08-24 |
| 1689991200 | Sean Brady Mcadams | Urology | 720 S Vanburen Street, Suite 301, Green Bay, WI 54301 | 2010-04-21 |
| 1740226265 | Myron M Marlett | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2006-06-22 |
| 1871988634 | Joshua T Piotrowski | Urology | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2015-03-30 |
| 1710305123 | Andrew Chandler Radtke | Urology | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2014-04-02 |
| 1134446339 | Christopher J Keto | Urology | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2010-04-27 |
| 1235399536 | Vannhu Nguyen | Urology | 2845 Greenbrier Rd, Ste 240, Green Bay, WI 54311-6519 | 2008-06-11 |
| 1609085612 | Michael Charles Mcmanus | Urology | 720 S Van Buren St, Ste 301, Green Bay, WI 54301-3538 | 2007-05-22 |
| 1013139641 | Heather M Stefaniak | Urology | 2845 Greenbrier Rd Ste 240, Green Bay, WI 54311-6519 | 2007-05-03 |
| 1043344005 | Richard Windsor | Urology | 2845 Greenbrier Rd, Suite 240, Green Bay, WI 54311-6519 | 2007-03-14 |
| Find all providers in GREEN BAY | ||||
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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.