MARIE ANTOINETTE KENNEDY
NPI 1851899140
Nurse Practitioner in Mishawaka, IN

Q: What is Marie Kennedy's NPI number?

The NPI number for Marie Kennedy is 1851899140. It was assigned to this individual provider in the NPPES registry on February 1, 2018.

Q: What is Marie Kennedy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Marie Kennedy was last updated on June 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since February 01, 2018PECOS EnrolledAccepts Medicare Assignment

611 E DOUGLAS RD STE 208, MISHAWAKA, IN 46545(574) 335-6000(574) 335-0738 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2024, Mar 5, 2024, Apr 10, 2019 and 2 more (5 updates tracked since 2019).

On this page

About Marie Antoinette Kennedy NPPES

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

MARIE ANTOINETTE KENNEDY (NPI 1851899140) is an individual nurse practitioner in Mishawaka, Indiana, licensed in Indiana (71007869A) and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1851899140

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARIE ANTOINETTE KENNEDY

Location Address611 E DOUGLAS RD STE 208Mishawaka, IN 46545-1465

Mailing Address707 Cedar St Ste 200South Bend, IN 46617-2057 · (574) 335-8707 · Fax (574) 335-0741

Phone(574) 335-6000

Fax(574) 335-0738

Sole ProprietorYes

Medical School CMSOtherGraduated 2005

Enumeration DateFebruary 1, 2018

Last NPPES UpdateJune 19, 20245 updates tracked since enumeration

NPPES CertifiedJune 19, 2024

✔ NPI 1851899140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 71007869A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 71007869A (IN), 28143781A (IN)

611 E DOUGLAS RD STE 208, Mishawaka, IN 46545

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Secondary Practice Locations 2

Location 11668 S US Highway 421Westville, IN 46391-9523 · Phone (219) 785-8424 · Fax (888) 692-8982

Location 23500 Franciscan Way Ste 400Michigan City, IN 46360-0033 · Phone (219) 878-8200 · Fax (219) 878-8331

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Marie Antoinette Kennedy 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 ID8820351190

PECOS Enrollment IDI20180419000968

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.

Hospital Affiliations CMS Care Compare

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

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150012

Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46545 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

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 6

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

EVONNE HIGDON NP

Nurse Practitioner