Active NPI
Timothy Kennedy, MS, ATC
- Athletic Trainer
- Cheektowaga, NY
National Provider Identifier
1043587751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 002084-1
- Practice address
- 4225 Genesee St
Cheektowaga, NY 14225-1994 - Phone
- (716) 204-3200
- NPI assigned
- Nov 23, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 002084-1 | NY | Primary |
Addresses
Primary practice location
4225 Genesee St
Cheektowaga, NY 14225-1994
Mailing address
34 Birchwood Ave Apt 5
West Seneca, NY 14224-2132
Phone (716) 515-8712
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 |
|---|---|---|---|
| 002084-1 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1043587751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 BIRCHWOOD AVE APT 5",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142242132",
"telephone_number": "716-515-8712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 GENESEE ST",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251994",
"telephone_number": "716-204-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "TIMOTHY",
"name_prefix": "Mr.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-23",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "002084-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.