Karen D Kennedy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040-0003294 Issued in VT

Practice address

21 Gregory Dr
Suite 120
South Burlington, VT 05403-6080

Phone

(802) 658-0949

NPI assigned

Jan 4, 2008

Last updated

Jan 4, 2008By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Poulin Performance, Inc.

  dba Poulin Performance and Rehabilitation Center

  • Physical Therapist
  • South Burlington, VT
  • NPI 1174553283
  NPD (past)

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1366627648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "address_2": "SUITE 120",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949",
            "fax_number": "802-658-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "address_2": "SUITE 120",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KAREN",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0003294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Pharmacy Inc (Custom Prescription Shoppe)
• Lisa Kelley, C.N.M.
• Ciera Kelly
• Jennifer J Kelly, DO
• Barbara C Kennedy, MD
• Kathryn Kennedy, DC
• Edward F. Kent Jr., MD
• Paul Francis Kenworthy, DMD
• Kenneth Kero, DDS
• Diane Pamela Kerr, RN BSN

• Physical Therapist in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.