Shannon M Kenneally, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60106210 Issued in WA

Practice address

3595 NW Bucklin Hill Rd
Silverdale, WA 98383-8503

Phone

(360) 698-3140

Fax

(360) 692-1441

NPI assigned

Oct 14, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kitsap Medical Supply, LLC

  • Durable Medical Equipment & Medical Supplies
  • Silverdale, WA
  • NPI 1750903639
  NPD (past)
• The Chiropractors Clinic, P.S.

  • Chiropractor
  • Silverdale, WA
  • NPI 1598846040
  NPD (past)

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1174858898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983830483",
            "telephone_number": "360-698-3140",
            "fax_number": "360-692-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838503",
            "telephone_number": "360-698-3140",
            "fax_number": "360-692-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEALLY",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60106210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Keeling, LMP
• Jordan Austin Keller
• Patrick W Kelley Jr.
• Monet Kelly
• Gabrielle Kemble, RD, CDE
• Claire Kennedy, PA-C
• Timothy Robert Kennedy, M.D.
• Kainoa M Kenzli, OD
• Kimber Marie Kenzli, OD
• Mary Martha Kerns, LMP

• Massage Therapist in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.