Individual provider Active NPI

Joseph S Kennedy, D.C.

  • Neurology Chiropractor
  • Chester, VA
National Provider Identifier
1164429734
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
104556184 Issued in VA
Practice address
10330 Iron Bridge Rd
Chester, VA 23831-1425
Phone
(804) 748-5748
Fax
(804) 523-8013
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 104556184 VA
Neurology Chiropractor 111NN0400X 104556184 VA Primary

Addresses

Primary practice location

10330 Iron Bridge Rd
Chester, VA 23831-1425

Mailing address

11148 Sterling Cove Dr
Chesterfield, VA 23838-5158
Phone (804) 305-5748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517000850 VA Practitioner - Chiropractic 1456341817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

209 Temple Ave
Colonial Heights, VA 23834-2827
Phone (804) 523-8023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104556184VAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Heights Chiropractic and Wellness Center, Inc. CurrentSince May 4, 2015 Accepting new patients
Chiropractic Centers, Inc Past Accepting new patients
Ironbridge Chiropractic Center, PLLC PastSince Oct 12, 2006 Accepting new patients

Locations

209 Temple Ave
Colonial Hgts, VA 23834
Phone (804) 290-2924

Organizations & group practices 3

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1164429734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11148 STERLING COVE DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238385158",
            "telephone_number": "804-305-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 IRON BRIDGE RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311425",
            "telephone_number": "804-748-5748",
            "fax_number": "804-523-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOSEPH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "104556184",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "VA",
            "license": "104556184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.