Active NPI
Kennedy Stewart, PT, DPT
- Physical Therapist
- Lawton, OK
National Provider Identifier
1104719145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6594
- Practice address
- 3401 W Gore Blvd
Lawton, OK 73505-6332 - Phone
- (580) 355-8620
- NPI assigned
- May 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6594 | OK | Primary |
Addresses
Primary practice location
3401 W Gore Blvd
Lawton, OK 73505-6332
Mailing address
3409 Jacquelyn Ter
Duncan, OK 73533-1199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Powerback Rehabilitation LLC
Practice addresses (Care Compare)
501 SE Flower Mound Rd
Lawton, OK 73501-6388
Phone (580) 771-3266
6302 SW Lee Blvd
Lawton, OK 73505-9100
Phone (580) 536-6800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broad River Rehabilitation | Multi-Specialty | Current | Accepting new patients |
Locations
1 Pond St
Arden, NC 28704
Phone 82877452220027
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748476800000",
"number": "1104719145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 JACQUELYN TER",
"city": "DUNCAN",
"state": "OK",
"postal_code": "735331199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 W GORE BLVD",
"city": "LAWTON",
"state": "OK",
"postal_code": "735056332",
"telephone_number": "580-355-8620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KENNEDY",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-29",
"last_updated": "2025-05-29",
"certification_date": "2025-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "OK",
"license": "6594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.