| Russell L Kennedy, DO | |
|
6151 N Main Street Rd, Webb City, MO 64870-8189 | |
| (417) 781-0408 | |
| (417) 556-5377 |
| Full Name | Russell L Kennedy |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 28 Years |
| Location | 6151 N Main Street Rd, Webb City, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316985989 | NPI | - | NPPES |
| P00800220 | Other | MO | RAIL ROAD MEDICARE |
| 200307600C | Medicaid | MO | |
| 200049470A | Medicaid | MO | |
| 1316985989 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2001014928 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Integrity Home Care + Hospice | Springfield, MO | Home health agency |
| Mercy Hospital Joplin | Joplin, MO | Hospital |
| Mercy Hospital Carthage | Carthage, MO | Hospital |
| Mercy Specialty Hospital Southeast Kansas | Galena, KS | Hospital |
| Freeman Health System - Freeman West | Joplin, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Clinic Joplin Llc | 0547300196 | 238 |
| Entity Name | Mercy Clinic Joplin Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215264817 PECOS PAC ID: 0547300196 Enrollment ID: O20091218000092 |
| Mailing Address | Practice Location Address |
|---|---|
| Russell L Kennedy, DO 6151 N Main Street Rd, Webb City, MO 64870-8189 Ph: (417) 781-0408 | Russell L Kennedy, DO 6151 N Main Street Rd, Webb City, MO 64870-8189 Ph: (417) 781-0408 |
Ms. Tracy Alaine Godfrey, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6151 N Main Street Rd, Webb City, MO 64870 Phone: 417-781-0408 Fax: 417-556-5377 | |
Dr. Justin Keith Hamlin, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1001 W Daugherty St, Webb City, MO 64870 Phone: 417-717-2017 Fax: 417-717-2134 | |
Glen W. King, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6151 N Main Street Rd, Webb City, MO 64870 Phone: 417-781-0408 Fax: 417-556-5377 | |
Mary L. Kennedy, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6151 N Main Street Rd, Webb City, MO 64870 Phone: 417-781-0408 Fax: 417-556-5377 |