KIMBERLY KENEHAN (NPI# 1457635278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457635278 |
| Entity Type | Individual |
| Full Name | KIMBERLY KENEHAN |
| Other Name | KIMBERLY PERON |
| Credential | PA-C |
| Practice Address |
150 Mundy St Mac Iv Building Wilkes Barre PA 18702-6830 |
| Practice Telephone | 5708240930 |
| Practice Fax Number | 5708247755 |
| Mailing Telephone | 5708240930 |
| Mailing Fax Number | 5708247755 |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2015-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA055239 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CAPITAL BLUE CROSS | 50104798 | 01 |
| Street Address |
150 MUNDY ST MAC IV BUILDING |
| City | WILKES BARRE |
| State | PA |
| Zip Code | 18702-6830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934088 | John Heinz Institute of Rehabilitation Medicine | Rehabilitation Hospital | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2005-07-07 |
| 1396359253 | Daniel Joseph Satterfield | Nurse Practitioner | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2020-09-08 |
| 1811508393 | Rheumatology & Arthritis Center of Wyoming Valley LLC | Internal Medicine | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2020-08-10 |
| 1821644360 | Grace Johna Olshefski | Nurse Practitioner | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2019-08-12 |
| 1740757822 | Jacqueline Pearson | Physical Therapist | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2018-10-27 |
| 1336639731 | North East Sleep Testing Center LLC | Clinic/Center | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702 | 2018-05-11 |
| 1366982266 | Caitlin Mesko | Physician Assistant | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702-6830 | 2017-02-27 |
| 1275076432 | Laura Decker | Massage Therapist | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2016-11-21 |
| 1992180004 | Allied Health Care Services | Community/Behavioral Health | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702-6830 | 2015-07-30 |
| 1548648975 | Joseph Dzurishin | Specialist | 150 Mundy St, Wilkes Barre, PA 18702-6830 | 2015-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153161 | Joann Bonn | Pharmacist | 441 Wilkes-barre Township Blvd, Wilkes-barre, PA 18702 | 2020-10-30 |
| 1689213167 | Megan Grace Zanghi | Pharmacist | 58-60 Public Square, 4th Floor, Wilkes-barre, PA 18702 | 2019-12-31 |
| 1467013292 | Kelly Rose Sones | Pharmacist | 58/60 Public Square, Wilkes-barre, PA 18702 | 2019-06-24 |
| 1528520186 | Adam Olivetti | Pharmacist | 58-60 Public Square, Wilkes-barre, PA 18702 | 2019-04-03 |
| 1295220648 | Dental Associates of Nepa PC | Dentist | 360 Kidder Street, Suite 5, Wilkes Barre, PA 18702 | 2018-06-28 |
| 1568983245 | Bio-medical Applications of Pennsylavania, Inc. | Clinic/Center | 309 Laird St, Wilkes-barre, PA 18702 | 2017-07-03 |
| 1538615166 | Elsa Gates | Nurse Practitioner | 100 East Mountain Blvd, Geisinger, Wilkes Barre, PA 18702 | 2016-09-01 |
| 1972990455 | Epeople Health Care Inc. | Home Health | 1092 Route 315, Ste 3, Wilkes Barre, PA 18702 | 2015-04-22 |
| 1063819001 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 277 Mundy St, Suite 101, Wilkes Barre, PA 18702 | 2014-11-19 |
| 1356764013 | Jill Stacchiotti | Speech-Language Pathologist | 2 Salem Drive, Laflin, PA 18702 | 2014-01-30 |
| Find all providers in zip 18702 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609802099 | Karen Anne Tillotson | Physician Assistant | 1000 E Mountain Blvd # 37-31, Wilkes Barre, PA 18711-0027 | 2006-06-25 |
| 1396342994 | Haley Stackhouse | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-10-06 |
| 1508405739 | Leah Alexandra Merrick | Physician Assistant | 575 N River St, Wilkes Barre, PA 18702-2634 | 2020-01-06 |
| 1699257576 | Kylen Larue | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2018-09-06 |
| 1124539044 | Tyler John Longstreet | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2017-10-18 |
| 1992256101 | Danielle Marie Yakup | Physician Assistant | 545 N River St, Suite 130, Wilkes Barre, PA 18702-2600 | 2016-10-23 |
| 1891248142 | Natalie Launchi | Physician Assistant | 1000 E Mountain Blvd, Critical Care Medicine, Wilkes Barre, PA 18711-0027 | 2016-08-03 |
| 1245600709 | Amy Marie Wierbowski | Physician Assistant | 1177 Highway 315 Blvd, Dolphin Plaza, Wilkes Barre, PA 18702-6928 | 2015-09-28 |
| 1538404058 | Katie Gad | Physician Assistant | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702-6830 | 2012-12-10 |
| 1194994459 | Eugenia Hopkins | Physician Assistant | 1000 East Mountain Blvd, Geisinger Wyoming Valley Cardiology Department, Wilkes Barre, PA 18711 | 2008-02-20 |
| Find all providers in WILKES BARRE | ||||
| City | WILKES BARRE |
| Zip Code | 18702 |
Please comment or provide details below to improve the information on KIMBERLY KENEHAN.
| 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.