Kelli Kennedy, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40483 Issued in FL

Practice address

834 Pinebrook Rd
Venice, FL 34285-7123

Phone

(941) 484-8107

Fax

(941) 484-5186

NPI assigned

Sep 28, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agility Physical Therapy and Sports Performance, LLCGroup PAC ID 3476684069, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Agility Physical Therapy & Sports Performance, LLC

  • Physical Therapist
  • Venice, FL
  • NPI 1154640027
  Medicare reassignment Care Compare group NPD
• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433
  Medicare reassignment NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Physical Therapist

  NPD
• Easter Seals Southwest Florida

  • Developmentally Disabled Services Day Training Agency
  • Sarasota, FL
  • NPI 1356513535
  NPD (past)

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1164201059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BRADEN AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 PINEBROOK RD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342857123",
            "telephone_number": "941-484-8107",
            "fax_number": "941-484-5186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10504 Wakeman Dr",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224078040",
            "country_code": "US",
            "telephone_number": "540-315-8249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Braden Ave",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342432001",
            "country_code": "US",
            "telephone_number": "941-355-7637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELLI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Keck, RPH
• Lynn Kelemen, L.M.H.C
• Kelly Marie Keller, APRN
• Melissa Kelley, ARNP
• Lauren Kenealy, APRN
• Zoe Kennedy
• Marcia Keperling, SLP
• Christopher Kerio, DC
• Kerry Kajdasz Lac, LLC
• Elena U Kesterson, PA

• Physical Therapist in Venice, FL
• Providers in Venice, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.