Active NPI
Heather Parker Kennedy, A.T.C.
- Athletic Trainer
- Conway, AR
National Provider Identifier
1245397389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 763
- Practice address
- 480 Exchange Ave
Conway, AR 72032-7808 - Phone
- (501) 336-6367
- NPI assigned
- Jan 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 289 | AR | |
| Athletic Trainer | 2255A2300X | 763 | OK | Primary |
Addresses
Primary practice location
480 Exchange Ave
Conway, AR 72032-7808
Mailing address
7801 E Boysen Dr
Claremore, OK 74019-3816
Phone (501) 428-3041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 763 | OK | MD | Marriage & Family Therapist |
| AT 289 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427414400000",
"number": "1245397389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7801 E BOYSEN DR",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740193816",
"telephone_number": "501-428-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 EXCHANGE AVE",
"city": "CONWAY",
"state": "AR",
"postal_code": "720327808",
"telephone_number": "501-336-6367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "HEATHER",
"middle_name": "PARKER",
"name_prefix": "Mrs.",
"credential": "A.T.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-01",
"last_updated": "2015-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT 289",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.