Shaina Summer Kennedy, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT007211 Issued in GA

Practice address

10144 Ford Ave
Richmond Hill, GA 31324-3936

Phone

(912) 727-2321

Fax

(912) 445-0599

NPI assigned

Nov 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1541808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1043788797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 CYRIL P BURKHALTER RD",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304274248",
            "telephone_number": "912-237-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10144 FORD AVE",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243936",
            "telephone_number": "912-727-2321",
            "fax_number": "912-445-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SHAINA",
        "middle_name": "SUMMER",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-10",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; 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.