Theresa Tustain Kennedy, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 908 Issued in HI

Practice address

1810 Makiki St
Honolulu, HI 96822-3266

Phone

(808) 729-7363

NPI assigned

Jun 19, 2007

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

Enrolled in HI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Mobile DSS, LLC

  dba Mobile Diagnostic Swallowing Services

  • Speech-Language Pathologist
  • Highlands Ranch, CO
  • NPI 1447829247

  HI

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1245435247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MAKIKI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223266",
            "telephone_number": "808-729-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MAKIKI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223266",
            "telephone_number": "808-729-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "THERESA",
        "middle_name": "TUSTAIN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2021-06-23",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "HI",
            "license": "SP 908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Kenn, RBT
• Kenneal Y C Chun MD LLC
• Kyle K Kennedy-Pocock, M.S.P.T.
• Katrena U. W. Kennedy, MD
• Reneau Charlene Kennedy, ED.D.
• Kenneth H. Arakawa, DDS, Inc.
• Kenneth Kau M.D., L.L.C.
• Kenneth M. Sunamoto, M.D., Inc
• Kenneth T. Kaan, MD., Inc
• Kenneth T. Yasuhara, DDS., Inc.

• Speech-Language Pathologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Speech-Language Pathologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.