MR. ERIC ALAN KENNEDY (NPI# 1841288701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841288701 |
| Entity Type | Individual |
| Full Name | MR. ERIC ALAN KENNEDY |
| Credential | PA-C |
| Practice Address |
52375 N Main St Mattawan MI 49071-9332 |
| Mailing Address |
601 John St Box 42 Kalamazoo MI 49007-5341 |
| Practice Telephone | 2696683348 |
| Practice Fax Number | 2696687702 |
| Mailing Telephone | 2693417806 |
| Mailing Fax Number | 2693418743 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601002670 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1841288701 | 05 | |
| MI | BCBSM | 700H060020 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386120905 | Eric F Kennedy | Licensed Practical Nurse | 17876 Saint Clair Ave, Cleveland, OH 44110-2602 | 2018-07-17 |
| 1346481116 | Eric Christopher Kennedy | Physical Therapist | 3213 Nazareth Rd, Easton, PA 18045-2000 | 2009-03-09 |
| Street Address |
52375 N MAIN ST |
| City | MATTAWAN |
| State | MI |
| Zip Code | 49071-9332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205835535 | Steve Elliot Reiman | Family Medicine | 52375 N Main St, Mattawan, MI 49071-9332 | 2005-07-19 |
| 1477976363 | Haley Crites | Physician Assistant | 52375 N Main St, Box 89, Mattawan, MI 49071-9332 | 2014-01-28 |
| 1598052433 | Angeli Certa | Pharmacist | 52375 N Main St, Mattawan, MI 49071-9332 | 2011-06-29 |
| 1447474267 | Bronson Lakeview Hospital | Family Medicine | 52375 N Main St, Mattawan, MI 49071-9332 | 2007-04-12 |
| 1205921251 | Jay Phillip Horwich | Orthopaedic Surgery | 52375 N Main St, Mattawan, MI 49071-9332 | 2006-10-04 |
| 1821081639 | Bronson Methodist Hospital | Pharmacy | 52375 N Main St, Mattawan, MI 49071-9332 | 2005-08-26 |
| 1326047358 | Laura Catherine Ford | Nurse Practitioner | 52375 N Main St, Mattawan, MI 49071-9332 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235617598 | Sheryl Ann Miller | Psychologist | 8570 Pq Avenue, Mattawan, MI 49071 | 2018-07-30 |
| 1568997054 | Willow Path Counseling Services | Community/Behavioral Health | 8089 Stadium Drive, Suite A, Kalamazoo, MI 49071 | 2017-04-22 |
| 1154508596 | Red Cedar Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 50762 Kiawah Trail, Suite B, Mattawan, MI 49071 | 2008-01-29 |
| 1639214794 | Rebecca Carr | Speech-Language Pathologist | 22899 Weather Vane Ct, Mattawan, MI 49071 | 2007-02-20 |
| 1891898730 | Edward I Porter | Counselor | 5500 Armstrong Road, Battle Creek Vamc, Battle Creek, MI 49071 | 2006-09-06 |
| 1376655365 | Mattawan Pharmacy | Pharmacy | 52366 N Main St, Mattawan, MI 49071-0069 | 2006-08-31 |
| 1164812491 | Sarah Mohney | Specialist/Technologist | 26402 Trestle Creek Ave, Mattawan, MI 49071-7713 | 2015-01-26 |
| 1114071487 | Shannon L Logsdon | Physical Therapist | 23200 Red Arrow Hwy Ste A, Mattawan, MI 49071-7754 | 2007-01-23 |
| 1447346036 | Kevin James Lacey | Physical Therapist | 23200 Red Arrow Hwy, A, Mattawan, MI 49071-7754 | 2006-10-04 |
| 1780002014 | Melissa Hulbert | Dental Hygienist | 23200 Red Arrow Hwy, Mattawan, MI 49071-7754 | 2014-04-03 |
| Find all providers in zip 49071 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
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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.