Kennedy Williams

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305216385 Issued in VA

Practice address

135 Hanbury Rd W Ste B
Chesapeake, VA 23322-4291

Phone

(757) 819-6512

NPI assigned

May 11, 2024

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

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1144078346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RILEY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233227420",
            "telephone_number": "757-549-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 HANBURY RD W STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224291",
            "telephone_number": "757-819-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gale Eugenia Williams, RPH
• Heather Williams
• Jennifer Marie Williams, MA
• Joshua Williams
• Kelsey E Williams
• Lamarco Williams
• Lazetta Williams
• Leigh Brandon Williams, RPH
• Michelle Denise Williams, CSAC
• N Wynta Williams, DPM

• Physical Therapist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.

Verify at the official NPI Registry.