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DR. ELAINE KENNEDY M.D.
NPI 1083634935
Pediatrics - Adolescent Medicine in Tahlequah, OK

Active since July 20, 2006PECOS Enrolled
100 S BLISS AVE, PEDIATRICS CLINIC, TAHLEQUAH, OK 74464(918) 458-3120 Get Directions Write a Review

NPPES record last updated: January 6, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Elaine Kennedy M.d. NPPES

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

DR. ELAINE KENNEDY M.D. (NPI 1083634935) is an individual adolescent medicine provider in Tahlequah, Oklahoma, licensed in Georgia (044765) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083634935
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameDR. ELAINE KENNEDYCredential: M.D.
Location Address100 S BLISS AVE, PEDIATRICS CLINICTahlequah, OK 74464-2512
Mailing Address1390 Heritage Ln, Pleasant View Apts # 92Tahlequah, OK 74464-2136
Phone(918) 458-3120
Sole ProprietorNo
Enumeration DateJuly 20, 2006
Last NPPES UpdateJanuary 6, 2011
✔ NPI 1083634935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Licenses✔ Licensed in GA · 044765✔ Licensed in WV · 22124✔ Licensed in KY · 34616✔ Licensed in SC · 21310✔ Licensed in AL · 00022200✔ Licensed in TN · MD0000010129
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
100 S BLISS AVE, Tahlequah, OK 74464
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Other Identifiers 1

Medicare UPINB03066

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Elaine Kennedy M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

PATRICK WAYNE SHARP DO
Emergency Medicine
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (189) 458-3100
HASTINGS INDIAN MEDICAL CENTER
General Acute Care Hospital (Rural)
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3100
DR. ADAM K RICHARDS DPT
Physical Therapist
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3491
JACOB EDWARD DICKERSON DNAP
Nurse Anesthetist, Certified Registered
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3100
DR. BARINDER PAUL BASSI DPM
Podiatrist
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 207-3780
DR. STEVEN RAY SCOTT PHARMD
Pharmacist (Pharmacotherapy)
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3100
MRS. CHERYL DELORES TARVER CNM
Advanced Practice Midwife
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3343
DR. GERALD RAY BROWN JR. PHARMD
Pharmacist
100 S BLISS AVE
TAHLEQUAH, OK 74464
Cherokee County (918) 458-3207

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elaine Kennedy's NPI number?

The NPI number for Elaine Kennedy is 1083634935. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Elaine Kennedy located?

Elaine Kennedy practices at 100 S Bliss Ave Pediatrics Clinic, Tahlequah, OK 74464. The listed phone number is (918) 458-3120.

What is Elaine Kennedy's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Elaine Kennedy enrolled in Medicare?

Yes. Elaine Kennedy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elaine Kennedy was last updated on January 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.