Active NPI
Amy L Kennedy, D.C.
- Chiropractor
- Rancho Palos Verdes, CA
National Provider Identifier
1124159413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC26747
- Practice address
- 28924 S Western Ave
Suite 208
Rancho Palos Verdes, CA 90275-0885 - Phone
- (310) 831-8833
- Fax
- (310) 831-8831
- NPI assigned
- Mar 8, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC26747 | CA | Primary |
Addresses
Primary practice location
28924 S Western Ave
Suite 208
Rancho Palos Verdes, CA 90275-0885
Mailing address
28924 S Western Ave
Suite 208
Rancho Palos Verdes, CA 90275-0885
Phone (310) 831-8833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800040509 | Other | CA | TAX IDENTIFICATION NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC26747 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300060800000",
"number": "1124159413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28924 S WESTERN AVE",
"address_2": "SUITE 208",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902750885",
"telephone_number": "310-831-8833",
"fax_number": "310-831-8831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28924 S WESTERN AVE",
"address_2": "SUITE 208",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902750885",
"telephone_number": "310-831-8833",
"fax_number": "310-831-8831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "AMY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2011-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC26747",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "800040509",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Palos Verdes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.