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

Allie Kennedy

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1689216251

Allie Kennedy is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2021, 5 years ago. Practices with St John Physicians, Inc, a 264-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1919 S Wheeling Ave Ste 500
Tulsa, OK 74104-5634
Phone: (918) 403-6284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9211 E 93rd Pl, Tulsa, OK 74133-5612 — (918) 606-8530

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 4763 (OK)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1689216251
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 15, 2019
Last updated in NPPESMarch 24, 2022
Certification dateMarch 24, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St. John Physicians, Inc. — 264 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Tulsa