Active NPI
Melissa Anne Kennedy, PTA
- Physical Therapy Assistant
- Wexford, PA
National Provider Identifier
1265878003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE009544
- Practice address
- 9850 Old Perry Hwy
Wexford, PA 15090-9311 - Phone
- (412) 847-7166
- NPI assigned
- May 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE009544 | PA | Primary |
Addresses
Primary practice location
9850 Old Perry Hwy
Wexford, PA 15090-9311
Mailing address
1640 S Keel Ridge Rd
Hermitage, PA 16148-9105
Phone (724) 815-3513
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 |
|---|---|---|---|
| TE009544 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1265878003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 S KEEL RIDGE RD",
"city": "HERMITAGE",
"state": "PA",
"postal_code": "161489105",
"telephone_number": "724-815-3513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 OLD PERRY HWY",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150909311",
"telephone_number": "412-847-7166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MELISSA",
"middle_name": "ANNE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-20",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE009544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.