KENEDI ELLEN ELIZABETH DIVINE MD
NPI 1275276560
Family Medicine in Jasper, IN
About Kenedi Ellen Elizabeth Divine Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENEDI ELLEN ELIZABETH DIVINE MD (NPI 1275276560) is an individual family medicine provider in Jasper, Indiana, licensed in Indiana (01096665A) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital And Health Care Center, and is a graduate of Indiana University School Of Medicine (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenedi Ellen Elizabeth Divine Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kenedi Divine reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jasper, IN 47546
- Reassigned Medicare billing, Indiana enrollment
- 444 clinicians in this Medicare group
Jasper, IN 47546
- Reassigned Medicare billing, Indiana enrollment
- 172 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Memorial Hospital And Health Care Center
Acute Care Hospitals · Jasper, INPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 47546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kenedi Divine's NPI number?
The NPI number for Kenedi Divine is 1275276560. It was assigned to this individual provider in the NPPES registry on April 15, 2022.
Where is Kenedi Divine located?
Kenedi Divine practices at 751 W 9th St, Jasper, IN 47546. The listed phone number is (812) 996-7474.
What is Kenedi Divine's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kenedi Divine enrolled in Medicare?
Yes. Kenedi Divine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kenedi Divine's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenedi Divine reassigns Medicare benefits to 2 organizations: Deaconess Clinic Inc (Jasper, IN) and Deaconess Memorial Medical Center Inc (Jasper, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenedi Divine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenedi Divine accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Kenedi Divine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kenedi Divine affiliated with any hospitals?
According to CMS data, Kenedi Divine is affiliated with Memorial Hospital And Health Care Center.
When was this NPI record last updated?
The NPPES record for Kenedi Divine was last updated on July 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Kenedi Ellen Elizabeth Divine, MD · NPI 1275276560
Family Medicine physician in Jasper, Indiana. Individual provider, active in the CMS NPPES registry since April 15, 2022.
## Identity
- **NPI:** 1275276560 (Entity type: Individual)
- **Enumerated:** April 15, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 01096665A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 751 W 9TH ST, Jasper, IN 47546-2609
- **Phone:** (812) 996-7474
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Deaconess Clinic Inc (NPI 1811788862, Jasper, IN); Deaconess Memorial Medical Center Inc (NPI 1972516110, Jasper, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Indiana University School Of Medicine, class of 2022
## Record status
- **NPPES last updated:** July 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1275276560) · Data from the CMS NPPES public registry.