KENNEDY CARE CENTER
NPI 1639803182
Skilled Nursing Facility in Los Angeles, CA

Active since July 11, 2022CLIA 05D0543713 · Waiver
619 N FAIRFAX AVE, LOS ANGELES, CA 90036(323) 651-0043 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 19, 2024, Aug 6, 2024, Jul 11, 2022 (3 updates tracked since 2022).

About Kennedy Care Center NPPES

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

KENNEDY CARE CENTER (NPI 1639803182) is a healthcare organization registered as a skilled nursing facility in Los Angeles, California and active in the NPI registry since July 2022. The organization holds a CLIA Waiver certificate valid through July 22, 2027 and lists John Mitchell, Secretary, as its authorized official.

NPPES Registry Identity

NPI1639803182
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFAIRFAX HEALTHCARE, LLC
Location Address619 N FAIRFAX AVELos Angeles, CA 90036-1714
Mailing Address262 N University AveFarmington, UT 84025-2975
Organization SubpartNo
Authorized OfficialJohn MitchellSecretary · (385) 988-3319
Enumeration DateJuly 11, 2022
Last NPPES UpdateAugust 19, 20243 updates tracked since enumeration
NPPES CertifiedAugust 19, 2024
NPI 1639803182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

619 N FAIRFAX AVE, Los Angeles, CA 90036

Other Names 1

Doing Business AsKennedy Care Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0543713

Kennedy Care Center · Los Angeles, CA
Active · expires Jul 22, 2027
CLIA Number05D0543713
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 23, 2025
Certificate Expiration DateJuly 22, 2027
Laboratory DirectorBrittany Brinley
Laboratory Phone(323) 651-0043
Laboratory LocationKennedy Care Center619 N Fairfax Ave, Los Angeles, CA 90036
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

Physical Medicine & Rehabilitation
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Skilled Nursing Facility
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Physical Therapy Assistant
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Occupational Therapist
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Physical Therapy Assistant
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Occupational Therapist
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Physical Therapist
619 N FAIRFAX AVE
LOS ANGELES, CA 90036
Physical Therapist
619 N FAIRFAX AVE
LOS ANGELES, CA 90036

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 Fairfax Healthcare, LLC's NPI number?

The NPI number for Fairfax Healthcare, LLC is 1639803182. It was assigned to this organization in the NPPES registry on July 11, 2022. The provider is doing business as Kennedy Care Center.

Where is Fairfax Healthcare, LLC located?

Fairfax Healthcare, LLC is located at 619 N Fairfax Ave, Los Angeles, CA 90036. The listed phone number is (323) 651-0043.

What is Fairfax Healthcare, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Fairfax Healthcare, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0543713) is associated with this NPI, valid through July 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fairfax Healthcare, LLC was last updated on August 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.