Jessie L. Kennedy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3771 Issued in TN

Practice address

900 Professional Park Dr
Clarksville, TN 37040-5244

Phone

(931) 552-3002

NPI assigned

Nov 1, 2011

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)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Broad River Rehabilitation

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1437435609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405244",
            "telephone_number": "931-552-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405244",
            "telephone_number": "931-552-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JESSIE",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "3771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Earl Lee Kelly, MD
• Gary Kelly, BC-HIS
• Kenneth Kelly, BC-HIS
• Matthew Kelly, BC-HIS
• Sydney Kelso, RBT
• Kevin Chambliss Kennedy Jr., DDS
• Victoria Kennedy
• Wikema I Kennedy, RN
• Stephen Warren Kent, M.D.
• Shawna Marie Kersh

• Speech-Language Pathologist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.