Patrick B Kennedy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

117802 Issued in MO

Practice address

2852 Independence St
Cape Girardeau, MO 63703-5016

Phone

(573) 335-2086

Fax

(573) 335-2398

NPI assigned

May 11, 2007

Sex

Male

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

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235344482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 ALBERT ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036505",
            "telephone_number": "573-335-2086",
            "fax_number": "573-335-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035016",
            "telephone_number": "573-335-2086",
            "fax_number": "573-335-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "PATRICK",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "117802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kelley
• Arielle Elizabeth Kelly, PMHNP-BC
• Carrie Ann Kennedy
• Jacquelyn Malia Kennedy
• Olivia Ann Kennedy, DO
• Kenneth a Decoursey, MD PC
• Cody Dylan Kern
• Jon-Erik W Kern, PTA
• Scott Thomas Kernan
• Deborah Lucille Kerr, PH.D.

• Physical Therapy Assistant in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.