Active NPI
Antoinette N Kennedy, MS OTR/L
- Occupational Therapist
- Winthrop, MA
National Provider Identifier
1023369808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2378
- Practice address
- 40 Upland Rd
Winthrop, MA 02152-1528 - Phone
- (617) 539-0488
- NPI assigned
- Sep 20, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2378 | MA | Primary |
Addresses
Primary practice location
40 Upland Rd
Winthrop, MA 02152-1528
Mailing address
40 Upland Rd
Winthrop, MA 02152-1528
Phone (617) 539-0488
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194703520 | Medicaid | MA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2378 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1023369808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 UPLAND RD",
"city": "WINTHROP",
"state": "MA",
"postal_code": "021521528",
"telephone_number": "617-539-0488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 UPLAND RD",
"city": "WINTHROP",
"state": "MA",
"postal_code": "021521528",
"telephone_number": "617-539-0488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ANTOINETTE",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "MS OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-20",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "2378",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194703520",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winthrop, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.