Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1215033402 Individual Practitioner Male Practitioner

Dr. Thomas James Kennedy , MD

Plastic Surgery • Bridgeport, WV

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Kennedy, MD is a registered healthcare professional specializing in Plastic Surgery in Bridgeport, WV. Practice services are available at 527 MEDICAL PARK DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

527 Medical Park Dr
Suite 203

Bridgeport, WV 263309007

Telephone 6813423190
Associated Practice Facility / Clinic
🏢 United Hospital Center Inc Facility NPI 1134101660

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Bridgeport, WV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 25.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Bridgeport, WV (25 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License WV WV20534

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery - Surgery of the Hand

NUCC Taxonomy Code: 2082S0105X

State License WV 20534

A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
3002519000 (WV)
Commercial Insurance / Payer ID Tax Id
550781237 (WV)
Commercial Insurance / Payer ID Fedworker's Compensation
350670000 (WV)
Commercial Insurance / Payer ID Health Plan
WV20534 (WV)
Commercial Insurance / Payer ID Worker's Comp Brick St
1056649 (WV)
Commercial Insurance / Payer ID Blue Cross/blue Shield
001722749 (WV)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Ronald Luethke , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1376518704

Doctor of Medicine (M.D.)

Cassidy Pinion

Physician Assistant

NPI 1497578066

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 08, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location June 08, 2011

Registered at 527 MEDICAL PARK DR, SUITE 203, BRIDGEPORT, WV 263309007 (Tel: 6813423190)

📍
Updated Business Mailing Address June 08, 2011

Registered at 527 MEDICAL PARK DR, SUITE 203, BRIDGEPORT, WV 263309007 (Tel: 6813423190)

👤
Provider Name / Credentials Updated June 08, 2011

Recorded as THOMAS KENNEDY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2011

Plastic Surgery (License #WV20534 in WV)

🟢
Initial NPI Registration & Enumeration September 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215033402
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2006
Last Update: June 08, 2011
Sole Proprietor: Yes

Mailing Address

527 Medical Park Dr, Suite 203

Bridgeport, WV 263309007

Phone: 6813423190

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.