Kennedy Poplawski Gillespie, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7973 Issued in ID

Practice address

90 E Ustick Rd Ste 150
Meridian, ID 83646-6134

Phone

(208) 895-0715

Fax

(208) 895-0746

NPI assigned

Nov 9, 2020

Last updated

Nov 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sports & Orthopedic Leaders Physical Therapy, Inc

  • Physical Therapist
  • Oakland, CA
  • NPI 1013981760
  NPD
• Intermountain Physical Therapy Limited Partnership

  • Physical Therapy Clinic/Center
  • Nampa, ID
  • NPI 1144334525

  Physical Therapist

  NPD (past)
• Intermountain Physical Therapy LP

  • Physical Therapy Clinic/Center
  • Nampa, ID
  • NPI 1073627451
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1003418765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E USTICK RD STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466134",
            "telephone_number": "208-895-0715",
            "fax_number": "208-895-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E USTICK RD STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466134",
            "telephone_number": "208-895-0715",
            "fax_number": "208-895-0746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6759 Sierra Ct",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "CA",
            "postal_code": "945682670",
            "country_code": "US",
            "telephone_number": "925-803-0530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 12th Ave S Ste 105",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836514660",
            "country_code": "US",
            "telephone_number": "208-467-4357",
            "fax_number": "208-467-4395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "KENNEDY",
        "middle_name": "POPLAWSKI",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299461",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "7973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omid Gilani, DDS
• Mary Christine Gilbert, RN
• Gregory Francis Gildea, DO
• Camryn Ann Giles
• Jonathan V. Giles, MD
• Kalli Ann Gillihan, FNP
• Tyler Gilliland, M.D.
• Ross Ginkel, PSY.D.
• Mary Ginnetti, LDN
• Emily Gire, OTD, OTR/L

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.