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

Mrs. Maryann Kenneson, MD

Individual provider Urology Physician · NPI 1790011062

Mrs. Maryann Kenneson, MD is an Urology in Orange Park, Florida. Graduated from University of Kentucky College of Medicine in 2003, 23 years ago. Practices with St Vincent's Ambulatory Care Inc, a 302-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and Ohio.

Years since qualifying
23
Trained at
University of Kentucky College of Medicine
Licensed in
FL, OH
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1895 Kingsley Ave Ste 903
Orange Park, FL 32073-4410
Phone: (904) 644-8353
Fax: (904) 644-8289
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence ME92864 (FL)
Urology Physician Taxonomy 208800000X · Licence 35098042 (OH)

Record details

NPI number1790011062
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 21, 2009
Last updated in NPPESFebruary 13, 2018

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice St Vincent'S Ambulatory Care Inc — 302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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