MR. ROGER KENNEDY – Professional Counselor, NPI 1891303152

MR. ROGER KENNEDY is a healthcare provider. based in Roseburg, Oregon. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. C7069 (OR). The NPI Number for MR. ROGER KENNEDY is 1891303152

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
MR. ROGER KENNEDY
NPI
1891303152
Phone
Not provided
Address
1652 NW HUGHWOOD CT
Enumeration Date
22 July 2020
Last Update Date
4 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5416733985
Graduation Year
2020 (6 years ago)
PAC ID
8628419405
Group Practice PAC ID
5496747552
Professional Enrollment ID
I20240510000622
Address ID
OR974718844RO1652XCTXX401

Contacts

Other Endpoint
Fax
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

1,181 MENTAL HEALTH COUNSELOR in OR

Provider Addresses for MR. ROGER KENNEDY

  • 1652 NW HUGHWOOD CT

    ROSEBURG, OR 974718844

    Phone:

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-05-10

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
I20240510000622IMental Health CounselorORTBD

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 97471)

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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: 5496747552View full group profile
NameSpecialtyState
Mental Health CounselorMT
Mental Health CounselorOR
Clinical PsychologistOR
-OR

Reviews

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Frequently asked questions

What is the standard ID for MR. ROGER KENNEDY in the U.S.?
In the U.S., MR. ROGER KENNEDY is identified by NPI 1891303152.
Should I treat MR. ROGER KENNEDY as an active provider?
Patients and plans typically see MR. ROGER KENNEDY as active in the national extract.
What type of care does MR. ROGER KENNEDY provide?
MR. ROGER KENNEDY's profile centers on Professional Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. ROGER KENNEDY?
MR. ROGER KENNEDY shows a connection to Roseburg, Oregon in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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