DR. JEREMY SCOTT KENNEDY (NPI# 1528022779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528022779 |
| Entity Type | Individual |
| Full Name | DR. JEREMY SCOTT KENNEDY |
| Credential | D.O. |
| Practice Address |
14506 W Granite Valley Dr #124 Sun City West AZ 85375-6010 |
| Mailing Address |
13943 N 91 Avenue C-101 Peoria AZ 85381-3629 |
| Practice Telephone | 6235842127 |
| Practice Fax Number | 6238541257 |
| Mailing Telephone | 6237609449 |
| Mailing Fax Number | 6139749351 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2016-01-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 5839 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | UNITED HEALTHCARE | 3437670 | 01 |
| AZ | AHCCCS | 707257 | 01 |
| AZ | RAILROAD MEDICARE | P01043135 | 01 |
| AZ | 707257 | 05 | |
| AZ | BLUE CROSS BLUE SHIELD | 1528022779 | 01 |
| HEALTH NET | 4Z8735 | 01 | |
| AZ | AETNA | 9558781 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982034286 | Jeremy Kennedy | Physical Therapist | 5413 Se Washington Street, Portland, OR 97215 | 2013-11-22 |
| 1134746639 | Jeremy Ryan Kennedy | Registered Nurse | 1600 W Avenue J, Lancaster, CA 93534-2894 | 2020-06-30 |
| 1467839407 | Jeremy Kennedy | Counselor | 50 Aldrin Rd, Plymouth, MA 02360-4827 | 2015-04-29 |
| Street Address |
14506 W GRANITE VALLEY DR #124 |
| City | SUN CITY WEST |
| State | AZ |
| Zip Code | 85375-6010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845383 | Susan M Dugo | Physical Therapist | 14506 W Granite Valley Dr, #205, Sun City West, AZ 85375-6010 | 2005-07-20 |
| 1568713980 | Sandra Henderson Densford | Counselor | 14506 W Granite Valley Dr, Suite # 221, Sun City West, AZ 85375-6010 | 2012-09-25 |
| 1831468297 | Sabvir Medical Associates, LLC | Internal Medicine | 14506 W Granite Valley Dr, #217, Sun City West, AZ 85375-6010 | 2011-12-14 |
| 1184949364 | Sandra Jean Lloyd | Counselor | 14506 W Granite Valley Dr, Suite 108, Sun City West, AZ 85375-6010 | 2010-03-31 |
| 1477789170 | Saguaro Internal Medicine, Pllc | Clinic/Center | 14506 W Granite Valley Dr, Ste 225, Sun City West, AZ 85375-6010 | 2009-06-09 |
| 1285871848 | Best Care, Pllc | Internal Medicine | 14506 W Granite Valley Dr, Suite 225, Sun City West, AZ 85375-6010 | 2009-01-19 |
| 1609028034 | Marilee Kyte | Counselor | 14506 W Granite Valley Dr, Suite #108, Sun City West, AZ 85375-6010 | 2008-10-16 |
| 1891963195 | Barbara Fong Md Pllc | Anesthesiology | 14506 W Granite Valley Dr, Suite 117, Sun City West, AZ 85375-6010 | 2008-02-20 |
| 1598945800 | General Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 14506 W Granite Valley Dr, #100, Sun City West, AZ 85375-6010 | 2007-11-05 |
| 1780872713 | Akdhc, LLC | Internal Medicine | 14506 W Granite Valley Dr, Ste 123, Sun City West, AZ 85375-6011 | 2007-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380662 | Melissa Darlene Ramirez | Nurse Practitioner | 14418 W Meeker Blvd Ste 100, Sun City West, AZ 85375 | 2018-06-15 |
| 1740798974 | Warner Steward | Physical Therapist | 14418 W Meeker Blvd, Ste 301, Bldg B, Sun City West, AZ 85375 | 2018-01-22 |
| 1154838589 | Bhsm Rehabilitation, LLC | Durable Medical Equipment & Medical Supplies | 14419 W Meeker, Sun City West, AZ 85375 | 2018-01-08 |
| 1467978320 | Nicole E Oppenheimer | Physician Assistant | 14416 W. Meeker Blvd, Ste 301, Sun City West, AZ 85375 | 2017-08-22 |
| 1134642838 | Jeffrey David Atkins | Physician Assistant | 14502 W Meeker Boulevard, Sun City West, AZ 85375 | 2017-07-25 |
| 1417486465 | Iora Senior Health, Inc | Internal Medicine | 13940 W. Meeker Blvd., Suite 101, Sun City West, AZ 85375 | 2017-06-05 |
| 1710224316 | Arizona Audiology & Hearing, Inc. | Audiologist-Hearing Aid Fitter | 13540 W. Camino Del Sol #20, Sun City West, AZ 85375 | 2013-01-16 |
| 1215280151 | Laura A L'heureux | Internal Medicine | 13949 W. Meeker Blvd, Suite D, Sun City West, AZ 85375 | 2012-10-16 |
| 1073872859 | Keith Arbuckle | Podiatrist | 13949 W Meeker Blvd Ste B, Sun City West, AZ 85375 | 2012-05-14 |
| 1285936336 | A-z Denture Center | Dentist | 19082 N. Rh Johnson Blvd, Sun City West, AZ 85375 | 2010-11-23 |
| Find all providers in zip 85375 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508893975 | Susan Whitmore | Dermatology | 14506 W Granite Valley Dr, #124, Sun City West, AZ 85375-6010 | 2006-06-28 |
| 1871546267 | John E Schlicher | Dermatology | 14506 W Granite Valley Dr, 124, Sun City West, AZ 85375-6010 | 2006-05-18 |
| 1144270059 | Anthony D Santos | Dermatology | 14416 W Meeker Blvd, Bldg C, Sun City West, AZ 85375-5284 | 2006-05-11 |
| 1447208822 | Elizabeth A Owen | Dermatology | 14506 W Granite Valley Dr, 124, Sun City West, AZ 85375-6010 | 2006-05-05 |
| 1265480644 | James W Groff | Dermatology | 14506 W Granite Valley Dr, 124, Sun City West, AZ 85375-6010 | 2006-05-05 |
| 1982687653 | Joseph P Fiore | Dermatology | 14506 W Granite Valley Dr, #124, Sun City West, AZ 85375-6010 | 2005-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215559471 | Innovative Dermatology Alliance Az, PC | Dermatology | 390 Bralliar Rd, Wickenburg, AZ 85390 | 2020-05-11 |
| 1902427735 | Derma Healthcare Solutions Pllc | Dermatology | 4716 E Thunderbird Rd, Phoenix, AZ 85032-5541 | 2020-05-04 |
| 1598310559 | Avant Dermatology & Aesthetics Pllc | Dermatology | 8580 N Oracle Rd Ste 140, Oro Valley, AZ 85704-6512 | 2019-08-07 |
| 1982268504 | Melody Maarouf | Dermatology | 7165 N Pima Canyon Dr, Tucson, AZ 85718-1407 | 2019-04-29 |
| 1114485646 | Saguaro Dermatology Associates LLC | Dermatology | 3400 E Mcdowell Rd Fl 2, Phoenix, AZ 85008-3884 | 2019-03-04 |
| 1114405503 | Joshua Harrison | Dermatology | 13771 N Fountain Hills Blvd # 114-103, Fountain Hills, AZ 85268-3762 | 2018-07-30 |
| 1386133684 | Az Mobile Derm Inc | Dermatology | 6857 E Beverly Ln, Scottsdale, AZ 85254-1566 | 2018-05-02 |
| 1225533409 | Rcdc of Mesa Plc | Dermatology | 270 W Chandler Heights Rd Ste 4, Chandler, AZ 85248-5084 | 2018-03-28 |
| 1548779713 | Ryan Kirk Bingham | Dermatology | 2855 E Brown Rd Ste 22, Mesa, AZ 85213-4216 | 2017-09-20 |
| 1306369996 | Clear Sky Dermatology LLC | Dermatology | 14044 W Camelback Rd Ste 220, Litchfield Park, AZ 85340-9426 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
| City | SUN CITY WEST |
| Zip Code | 85375 |
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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.