Basic Information
| Provider Information | |||||||||
| NPI: | 1497780548 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KENNEY | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1085 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SOUTH WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021901547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813312922 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 217836 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | COVENTRY | OTHER | 217836 | 01 | TUFTS AND TMP | OTHER | 7766145 | 01 | AETNA | OTHER | 042297845 | 01 | MUTIPLAN | OTHER | 110034628A | 05 | MA | MEDICAID | AA174499 | 01 | MA | HARVARD PILGRIM | OTHER | SS0068 | 01 | MA | BCBSMA | OTHER | 042297845 | 01 | UNITED HEALTH CARE | OTHER | 6036494 | 01 | CIGNA | OTHER |