Kennedi Van Eyken, ATC/LAT

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

A0001123 Issued in MD

Practice address

1700 E Cold Spring LN
Baltimore, MD 21251-0001

Phone

(443) 885-3333

NPI assigned

Sep 27, 2018

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1073098778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E COLD SPRING LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212510001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E COLD SPRING LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212510001",
            "telephone_number": "443-885-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN EYKEN",
        "first_name": "KENNEDI",
        "credential": "ATC/LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "MD",
            "license": "A0001123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van Dyke and Bacon Inc.
• Katlyn Bostic Van Dyke, AU.D.
• Van E. Lomis, MD LLC
• Kathryn Van Eck
• Amy Van Ee
• Evelien Van Gelderen
• Andrea Sadey Van Horn, CNP
• Kristen Van Leen, CCC-SLP
• Austin Van Niel, DO
• Cheryl A Van Rensselaer, PT

• Sports Medicine (Internal Medicine) Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Sports Medicine (Internal Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.