Joseph A Kennedy, OTHER

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1117 Issued in AK

Practice address

902 E Lincoln Rd
Idabel, OK 74745-7337

Phone

(580) 286-2600

Fax

(580) 286-1107

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joseph.kennedy.1@15989.direct.athenahealth.com

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

• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment Care Compare group NPD
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1013087063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MILES ST",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747284507",
            "telephone_number": "580-236-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600",
            "fax_number": "580-286-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "credential": "OTHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "1117",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA PT LICENSE",
            "identifier": "4463",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessika Rena Jones
• Shamaria Lashay Jones
• Stephen John Karman, MD
• Stephen Jerome Katz, M.D.
• David Earl Kemp
• Carol Ann Kerr, M.D.
• Olga Khudoley
• Kiamchi Youth Services Inc
• Kiamichi Council on Alcohoism and Other Drug Abuse Inc.
• Kiamichi Council on Alcoholism and Or Other Drug Abuse, Inc.

• Physical Therapist in Idabel, OK
• Providers in Idabel, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.