Individual provider Active NPI

Katrina Kennedy, PT, DPT, ATC

  • Physical Therapist
  • Chagrin Falls, OH
National Provider Identifier
1407287600
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014570 Issued in OH
Practice address
34 W Washington St
Chagrin Falls, OH 44022-3026
Phone
(440) 247-2644
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 014570 OH Primary

Addresses

Primary practice location

34 W Washington St
Chagrin Falls, OH 44022-3026

Mailing address

34 W Washington St
Chagrin Falls, OH 44022-3026

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
014570OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1407287600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 W WASHINGTON ST",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 W WASHINGTON ST",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223026",
            "telephone_number": "440-247-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATRINA",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "014570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.