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

Nicole Lynette Kennedy, MD

Individual provider Family Medicine Physician · NPI 1780902486

Nicole Lynette Kennedy, MD is a Family Practice in Marion, Illinois. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 2010, 16 years ago. Practices with Select Physical Therapy Holdings Inc, a 2,121-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and South Carolina.

Years since qualifying
16
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
IL, SC
In the registry since
2010
Specialties on file
3
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

3411 Professional Park Drive Simca
Marion, IL 62959
Phone: (618) 997-2161
Fax: (618) 997-2464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036132187 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 32561 (SC)
Hospitalist Physician Taxonomy 208M00000X · Licence 036132187 (IL)

Record details

NPI number1780902486
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 6, 2010
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 2010 (16 years in practice)
Group practice Select Physical Therapy Holdings Inc — 2121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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