BETHANY LOU FIEBELKORN KENNEDY PH.D.
NPI 1598917692
Psychologist in Coon Rapids, MN

Active since October 21, 2008PECOS EnrolledAccepts Medicare Assignment
9145 SPRINGBROOK DR NW, COON RAPIDS, MN 55433(612) 871-1145 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 21, 2016, Jun 21, 2016 (2 updates tracked since 2016).

About Bethany Lou Fiebelkorn Kennedy Ph.d. NPPES

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

BETHANY LOU FIEBELKORN KENNEDY PH.D. (NPI 1598917692) is an individual psychologist in Coon Rapids, Minnesota, licensed in Minnesota (LP5963) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1598917692
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameBETHANY LOU FIEBELKORN KENNEDYCredential: PH.D.
Location Address9145 SPRINGBROOK DR NWCoon Rapids, MN 55433-5885
Mailing AddressPo Box 14909Minneapolis, MN 55414-0909 · (612) 871-1145
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 21, 2008
Last NPPES UpdateAugust 31, 20212 updates tracked since enumeration
NPPES CertifiedAugust 31, 2021
✔ NPI 1598917692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MN · LP5963
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
9145 SPRINGBROOK DR NW, Coon Rapids, MN 55433

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

Bethany Lou Fiebelkorn Kennedy Ph.d. 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 ID4688966336
PECOS Enrollment IDI20160718000163
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Bethany Fiebelkorn Kennedy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gastroenterology
3001 BROADWAY ST NE STE 500
Minneapolis, MN 55413
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Mngi Digestive Health PA
  • 322 clinicians in this Medicare group
Clinic/Center
300 S 6TH ST, GOVERNMENT CENTER-A 120
Minneapolis, MN 55487
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,247 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.

Areas of Expertise CMS Part B claims 3

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.

Treatment of behavior impacting health, each additional 15 minutes 96159
This procedure involves therapeutic interventions to help manage behaviors that may negatively affect your health. Each additional 15-minute session is designed to further assist in developing healthier habits and coping mechanisms.
163 services37 patients
Treatment of behavior impacting health, initial 30 minutes 96158
This service involves a healthcare professional working with you for 30 minutes to address behaviors that are negatively affecting your health. They will help you understand and modify these behaviors, improving your overall well-being.
156 services38 patients
Assessment of health behavior 96156
Assessment of health behavior is a process where your daily habits and lifestyle choices are evaluated. This includes your diet, exercise, sleep patterns, and stress management. The goal is to identify areas for improvement and develop strategies for healthier habits.
27 services27 patients

Other Providers at the Same Location NPPES 9

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

Internal Medicine (Gastroenterology)
9145 SPRINGBROOK DR NW, SUITE 200
COON RAPIDS, MN 55433
Internal Medicine (Gastroenterology)
9145 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Nurse Practitioner (Family)
9145 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Dentist (Oral and Maxillofacial Surgery)
9145 SPRINGBROOK DR NW, SUITE 100
COON RAPIDS, MN 55433
Internal Medicine (Gastroenterology)
9145 SPRINGBROOK DR NW, SUITE 200
COON RAPIDS, MN 55433
Physician Assistant
9145 SPRINGBROOK DR NW, SUITE 200
COON RAPIDS, MN 55433
Internal Medicine (Gastroenterology)
9145 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Dentist (General Practice)
9145 SPRINGBROOK DR NW, SUITE 100
COON RAPIDS, MN 55433

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 Bethany Fiebelkorn Kennedy's NPI number?

The NPI number for Bethany Fiebelkorn Kennedy is 1598917692. It was assigned to this individual provider in the NPPES registry on October 21, 2008.

Where is Bethany Fiebelkorn Kennedy located?

Bethany Fiebelkorn Kennedy practices at 9145 Springbrook Dr NW, Coon Rapids, MN 55433. The listed phone number is (612) 871-1145.

What is Bethany Fiebelkorn Kennedy's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Bethany Fiebelkorn Kennedy enrolled in Medicare?

Yes. Bethany Fiebelkorn Kennedy 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 Bethany Fiebelkorn Kennedy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bethany Fiebelkorn Kennedy reassigns Medicare benefits to 2 organizations: Mngi Digestive Health, P.A. (Minneapolis, MN) and Hennepin Healthcare System, Inc (Minneapolis, MN). 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 Bethany Fiebelkorn Kennedy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bethany Fiebelkorn Kennedy was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.