Lyman Kennedy Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6303 Issued in CA

Practice address

1040 Elm Ave
Suite #100
Long Beach, CA 90813-3264

Phone

(562) 591-4444

Fax

(562) 436-7350

NPI assigned

Sep 12, 2007

Last updated

Jan 16, 2013By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1467647511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE",
            "address_2": "SUITE #100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133264",
            "telephone_number": "562-591-4444",
            "fax_number": "562-436-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE",
            "address_2": "SUITE #100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133264",
            "telephone_number": "562-591-4444",
            "fax_number": "562-436-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LYMAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "6303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Ira Kenigsberg, PH.D.
• Bernadette Marlene Kennard
• Ashley Paige Kennedy
• Chrissy Kennedy
• Lakisha Dominique Kennedy
• Robert M Kennedy, DC
• Tyler Kennedy
• Kenneth Jay Wepman DPM
• Kenneth M. Lee Chiropractic, Inc.
• Kenny Abedini DDS Inc.

• Physical Therapist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.