Active NPI
Kennedy Alise Graves
- Student in an Organized Health Care Education/Training Program
- Columbus, OH
National Provider Identifier
1003543042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 615 Irving Schottenstein Dr
Columbus, OH 43210-1069 - Phone
- (614) 293-1634
- NPI assigned
- Aug 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
615 Irving Schottenstein Dr
Columbus, OH 43210-1069
Mailing address
9739 Troon CT
Blue Ash, OH 45241-3349
Phone (513) 484-2822
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1003543042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9739 TROON CT",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452413349",
"telephone_number": "513-484-2822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 IRVING SCHOTTENSTEIN DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101069",
"telephone_number": "614-293-1634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "KENNEDY",
"middle_name": "ALISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-01",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.