Kennedy Chiropractic Health Center

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104555747 Issued in VA

Legal business name

KENNEDY CHIROPRACTIC HEALTH CENTER

Doing business as

ALLSPORTS PHYSICAL MEDICINE CENTER

Practice address

45 Marketplace Dr
Suite 102
Rocky Mount, VA 24151-6516

Phone

(540) 483-3678

Fax

(540) 483-3820

NPI assigned

Jan 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mia M Kennedy, D.C.

Title

Owner

Phone

(540) 483-3678

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• ALLSPORTS PHYSICAL MEDICINE CENTER Doing business as

Locations

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396896148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 SALISBURY DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184116",
            "telephone_number": "540-400-0036",
            "fax_number": "540-483-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MARKETPLACE DR",
            "address_2": "SUITE 102",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241516516",
            "telephone_number": "540-483-3678",
            "fax_number": "540-483-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY CHIROPRACTIC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-483-3678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104555747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM DRCOLLINS PROVIDER",
            "identifier": "182483",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "285308",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "317684",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALLSPORTS PHYSICAL MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellen Kaltenbach, PHARM. D.
• Deborah D Kapsalakis, SLP
• Kartesz Family Eye Care Inc
• Cheryl L Kelley, PT
• John H Kelly Jr., MD
• Avery E Kerr, L.P.C.
• Carolyn Anne Kilbane, PHARMD
• Ashley King, LPC
• Gary Lee Klink, O.D.
• Deanna Pendrey Knox, ED.S.

• Sports Physician Chiropractor in Rocky Mount, VA
• Providers in Rocky Mount, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.