Active NPI
Darrelle Kennedy
- Physical Therapy Assistant
- Sarasota, FL
National Provider Identifier
1144872367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A6881
- Practice address
- 5659 Creekwood Cir
Sarasota, FL 34233-1532 - Phone
- (910) 231-6146
- NPI assigned
- Jul 9, 2019
- Sex
- Male
- 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 Therapy Assistant | 225200000X | A6881 | NC | Primary |
Addresses
Primary practice location
5659 Creekwood Cir
Sarasota, FL 34233-1532
Mailing address
5659 Creekwood Cir
Sarasota, FL 34233-1532
Phone (910) 231-6146
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Casamba | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| A6881 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1144872367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5659 CREEKWOOD CIR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342331532",
"telephone_number": "910-231-6146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5659 CREEKWOOD CIR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342331532",
"telephone_number": "910-231-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "DARRELLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A6881",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Casamba",
"affiliation": "N",
"endpointDescription": "Software",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5659 Creekwood Cir",
"city": "Sarasota",
"state": "FL",
"country_code": "US",
"postal_code": "342331532",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sarasota, FL
- Kennedy Chiropractic Clinic, Inc
- Kennedy White & Riggs Orthopedic Associates (Kennedy-White Orthopaedic Center)
- Kennedy White & Riggs Orthopedic Associates (Kennedy-White Orthopaedic Center)
- Kennedy White & Riggs Orthopedic Associates (Kennedy-White Orthopaedic Center)
- Kennedy White & Riggs Orthopedic Associates (Kennedy-White Orthopedic Center)
- Desiree Ann Kennedy
- Heather Kennedy, PT
- Jamie Lee Kennedy, MSN, APRN, FNP-C
- Kathleen M Kennedy, M.D.
- Kimberly Kennedy, MPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.