Individual provider Active NPI

Kennedy Johnson

  • Occupational Therapist
  • Hixson, TN
National Provider Identifier
1467211342
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2143 Northpoint Blvd
Hixson, TN 37343-4697
Phone
(423) 847-2646
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

2143 Northpoint Blvd
Hixson, TN 37343-4697

Mailing address

8520 Kensley LN
Hixson, TN 37343-5890

Other practice location 1

2760 Northpoint Blvd
Hixson, TN 37343-6338
Phone (423) 777-8077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000537 TN Practitioner - Occupational Therapist in Private Practice 0648617860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

1020 Charlie Daniels Pkwy
Mount Juliet, TN 37122-3064
Phone (877) 367-9772

2760 Northpoint Blvd
Hixson, TN 37343-6338
Phone (423) 225-7712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7090TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Mar 14, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Mar 14, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

1020 Charlie Daniels Pkwy
Mt Juliet, TN 37122
Phone (615) 758-4800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1467211342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8520 KENSLEY LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 NORTHPOINT BLVD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434697",
            "telephone_number": "423-847-2646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2760 Northpoint Blvd",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373436338",
            "country_code": "US",
            "telephone_number": "423-777-8077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.