MR. EMMET MICHAEL KENNEY JR. (NPI# 1902998081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902998081 |
| Entity Type | Individual |
| Full Name | MR. EMMET MICHAEL KENNEY JR. |
| Credential | MD |
| Practice Address |
3201 33rd St S Fargo ND 58104-8823 |
| Practice Telephone | 7013654488 |
| Practice Fax Number | 7013650727 |
| Mailing Telephone | 7013654488 |
| Mailing Fax Number | 7013650727 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MN32170 | MN | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ND7174 | ND | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
MN32170 | MN | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
ND7174 | ND | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MN32170 | MN | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
ND7174 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 18353 | 05 | |
| MN | 597823800 | 05 | |
| ND | BCBS | 22028 | 01 |
| Street Address |
3201 33RD ST S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-8823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908455 | Jordan Ann Wiedmann | Physician Assistant | 3201 33rd St S, Fargo, ND 58104-8823 | 2020-06-29 |
| 1134781321 | Rachel Sauter | Registered Nurse | 3201 33rd St S, Fargo, ND 58104-8823 | 2019-07-08 |
| 1578127288 | Aminata Sankoh Kamara | Nurse Practitioner | 3201 33rd St S, Fargo, ND 58104-8823 | 2019-04-29 |
| 1336443654 | St. Sophie's, LLC | Clinic/Center | 3201 33rd St S, Fargo, ND 58104-8823 | 2010-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346479185 | Nivedita Sudhir Nadkarni | Psychiatry & Neurology | 1702 University Drive South, Fargo, ND 58103 | 2009-07-14 |
| 1538218391 | Jane Charlotte Gaffrey | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2007-01-10 |
| 1306867528 | Jeanine L Roembach | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-22 |
| 1982622528 | Kenneth J Fischer | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124064431 | Laura B Schield | Psychiatry & Neurology | 2787 97th Ave Nw, Bismarck, ND 58503-8452 | 2006-06-22 |
| 1376958397 | Kenneth Chidi Asogwa | Psychiatry & Neurology | 860 S Columbia Rd, Grand Forks, ND 58201 | 2014-06-28 |
| 1245541895 | Stephanie Jallen | Psychiatry & Neurology | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2010-06-29 |
| 1619297785 | Jacqueline M Bell | Psychiatry & Neurology | 1900-8th Ave. S.e., Minot, ND 58701-4935 | 2010-06-10 |
| 1003952144 | Kondal Madaram | Psychiatry & Neurology | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2007-01-29 |
| 1326119884 | Deidre L Richards | Psychiatry & Neurology | 1900 8th Ave Se, Minot, ND 58701-4935 | 2006-11-13 |
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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.