JACY L KENNEDY (ARNP) – Family Nurse Practitioner, NPI 1134780968

JACY L KENNEDY (ARNP) is a healthcare provider. based in Ottumwa, Iowa. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. A155098 (IA). The NPI Number for JACY L KENNEDY (ARNP) is 1134780968

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JACY L KENNEDY (ARNP)
NPI
1134780968
Phone
(641) 682-5437
Address
1207 N JEFFERSON ST STE 1
Enumeration Date
24 June 2019
Last Update Date
24 June 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6416848448
Graduation Year
2019 (7 years ago)
PAC ID
5092160606
Group Practice PAC ID
6305736026
Professional Enrollment ID
I20231017000393
Address ID
IA525012576OT301XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,529 NURSE PRACTITIONER in IA

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Provider Addresses for JACY L KENNEDY (ARNP)

  • North Jefferson Street, Ottumwa, Wapello County, Iowa, 52501, United States

    OTTUMWA, IA 525012021

    Phone: (641) 682-5437

    Fax: (641) 682-1628

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $406.

Total Amount is formed as General ($406) + Research ($0) + Ownership ($0) = $406.

Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Corium, LLC ($98).

Total Amount

$406

General + Research + Ownership

Payments

20

Total payment records

General Amount

$406

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-28

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231017000393INurse PractitionerIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 52501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305736026View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineIA
Nurse PractitionerIA
P O D I A T R YIA
Nurse PractitionerIA

Reviews

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Frequently asked questions

Can I use this page to confirm JACY L KENNEDY (ARNP)'s NPI?
Yes. JACY L KENNEDY (ARNP) is listed with NPI 1134780968 in the public NPI dataset.
Can I rely on JACY L KENNEDY (ARNP) being an active provider?
As of the registry snapshot, JACY L KENNEDY (ARNP) is marked active.
What taxonomy line describes JACY L KENNEDY (ARNP)?
For research purposes, treat JACY L KENNEDY (ARNP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is JACY L KENNEDY (ARNP) based?
JACY L KENNEDY (ARNP) is tied to Ottumwa, Iowa in the data we show; additional addresses may exist on the full record.
Is the information about JACY L KENNEDY (ARNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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