MR. ETHAN RAYMOND KENNEY PHYSICIAN ASSISTANT
NPI 1346870821
Physician Assistant in Charlotte, NC

Q: What is Ethan Kenney's NPI number?

The NPI number for Ethan Kenney is 1346870821. It was assigned to this individual provider in the NPPES registry on January 23, 2020.

Q: What is Ethan Kenney's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Kenney was last updated on February 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 23, 2020PECOS EnrolledAccepts Medicare Assignment

15830 BALLANTYNE MEDICAL PL STE 275, CHARLOTTE, NC 28277(980) 302-8659(980) 302-8674 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 13, 2022, Apr 5, 2022, Oct 26, 2020 and 2 more (5 updates tracked since 2020).

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About Mr. Ethan Raymond Kenney Physician Assistant NPPES

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

MR. ETHAN RAYMOND KENNEY PHYSICIAN ASSISTANT (NPI 1346870821) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-09714) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1346870821

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. ETHAN RAYMOND KENNEYCredential: PHYSICIAN ASSISTANT

Location Address15830 BALLANTYNE MEDICAL PL STE 275Charlotte, NC 28277-4791

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (980) 302-8659 · Fax (980) 302-8674

Phone(980) 302-8659

Fax(980) 302-8674

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJanuary 23, 2020

Last NPPES UpdateFebruary 12, 20245 updates tracked since enumeration

NPPES CertifiedFebruary 12, 2024

✔ NPI 1346870821 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-09714

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

15830 BALLANTYNE MEDICAL PL STE 275, Charlotte, NC 28277

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Secondary Practice Locations 3

Location 11640 E Roosevelt BlvdMonroe, NC 28112-4017 · Phone (704) 226-0500 · Fax (704) 226-0599

Location 2330 Billingsley Rd Ste 202Charlotte, NC 28211-5020 · Phone (704) 316-3070

Location 32801 Randolph Rd Ste 100Charlotte, NC 28211-1051 · Phone (704) 367-4800 · Fax (704) 316-3025

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Ethan Raymond Kenney Physician Assistant 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.

PECOS PAC ID2365873957

PECOS Enrollment IDI20200514002925

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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

182 services156 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

77 services54 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

59 services59 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

49 services46 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

41 services41 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

22 services22 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340053

Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County

Emergency services Birthing friendly

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340171

Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County

Emergency services Birthing friendly

Novant Health Ballantyne Medical Center

Acute Care Hospitals · Charlotte, NC

OwnershipVoluntary non-profit - Private

CMS Certification Number340195

Location10905 Providence Road WCharlotte, NC 28277 · Mecklenburg County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

SAMEER SADASHIV CHAUDHARI M.D.

Internal Medicine (Cardiovascular Disease)