Maria Basilio Kennedy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5686 Issued in NC

Practice address

1315 S Hawthorne Rd
Winston Salem, NC 27103-4121

Phone

(336) 917-6000

Fax

(336) 917-6003

NPI assigned

Jul 31, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Aware Physical Therapy,LLC

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1043528763
  NPD

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184000119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034121",
            "telephone_number": "336-917-6000",
            "fax_number": "336-917-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034121",
            "telephone_number": "336-917-6000",
            "fax_number": "336-917-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARIA",
        "middle_name": "BASILIO",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5686",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "5686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Kennaw, RBT
• Austin Kennedy
• Daniel Joseph Kennedy, M.D.
• Jeanine Rivituso Kennedy, R.D., L.D.N.
• Leanne Davidson Kennedy, PHARMD
• Michael Elizabeth Kennedy, ANP, AG-ACNP
• Michael S Kennedy, R.PH.
• Sara Kennedy
• Kenneth M. Sadler DDS & Associates, PA
• Kenneth R,. Russell, D.D.S. PA

• Physical Therapy Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.