Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kennett Pediatrics and Adolescents Medicine LLC

Organization Pediatrics Physician · NPI 1063414704

Kennett Pediatrics and Adolescents Medicine LLC is a Pediatrics Physician in Kennett, Missouri. Licensed in Missouri. Registered with an NPI since 2005.

Licensed in
MO
In the registry since
2005
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

211 Teaco Rd
Kennett, MO 63857-3236
Phone: (573) 888-0001
Fax: (573) 888-0006
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Pediatrics Physician Taxonomy 208000000X (MO)

Record details

NPI number1063414704
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Beach — Md Owner · (573) 888-0001
NPI enumeratedAugust 12, 2005
Last updated in NPPESJuly 21, 2022
Mailing addressPo Box 908, Kennett, MO 63857-0908

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