Grace Marie Kennedy

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT005627 Issued in OH

Practice address

366 Richland Ave Apt 4203B
Athens, OH 45701-3258

Phone

(302) 381-4941

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

Yes

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1366937104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 RUSTIC LN",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199018742",
            "telephone_number": "302-381-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 RICHLAND AVE APT 4203B",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013258",
            "telephone_number": "302-381-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT005627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Kellough
• Nina Kelly, DPT
• John Joseph Kemerer, D.O.
• Samantha Kempker, MA
• Stephanie Rose Kendrick, CDCA
• Kristina M. Kennedy, D.C.
• Melissa Kennedy
• Nicole K.a. Kennedy, LISW
• Patricia Kennedy
• Timothy Tulley Kermode, D.O.

• Athletic Trainer in Athens, OH
• Providers in Athens, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.