Miriam Kennetz, MOTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6034 Issued in TN

Practice address

600 Jefferson Ave
Memphis, TN 38105-4934

Phone

(901) 287-4900

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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.

• Kennetz Kids OT

  • Pediatric Occupational Therapist
  • Bartlett, TN
  • NPI 1558180505

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1184243750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SAINT AGNES DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381124716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054934",
            "telephone_number": "901-287-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNETZ",
        "first_name": "MIRIAM",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "6034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Duck Kennedy, MA
• Erin Brower Kennedy, PHARMD
• Lisa Kennedy, MD
• Matthew Kennedy
• Richard Kennedy
• Connor L Kenney, M.D.
• Brooke Ashton Kennon, DNP APRN AG-ACNP-BC
• Patricia Carolyn Kent-Hines, LPN
• Chloe Kent, DO
• Monica Renae Kent

• Pediatric Occupational Therapist in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatric Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.