KENNETT PEDIATRICS AND ADOLESCENTS MEDICINE LLC
NPI 1063414704
Clinic/Center - Rural Health in Kennett, MO

Q: What is Kennett Pediatrics And Adolescents Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since August 12, 2005

211 TEACO RD, KENNETT, MO 63857(573) 888-0001(573) 888-0006 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kennett Pediatrics And Adolescents Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETT PEDIATRICS AND ADOLESCENTS MEDICINE LLC (NPI 1063414704) is a healthcare organization registered as a rural health in Kennett, Missouri and active in the NPI registry since August 2005. The organization lists Andrew C Beach, Md Owner, as its authorized official.

NPPES Registry Identity

NPI1063414704

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameKENNETT PEDIATRICS AND ADOLESCENTS MEDICINE LLC

Location Address211 TEACO RDKennett, MO 63857-3236

Mailing AddressPo Box 908Kennett, MO 63857-0908 · (573) 888-0001 · Fax (573) 888-0006

Phone(573) 888-0001

Fax(573) 888-0006

Organization SubpartNo

Authorized OfficialAndrew C BeachMd Owner · (573) 888-0001

Enumeration DateAugust 12, 2005

Last NPPES UpdateJuly 21, 2022

✔ NPI 1063414704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedPediatricsTaxonomy 208000000X

211 TEACO RD, Kennett, MO 63857

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Other Identifiers 1

Medicaid599371408MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GINGER L SMITH APRN NP-C

Nurse Practitioner