Individual provider Active NPI

Jodi Elizabeth Kennedy, D.C.

  • Chiropractor
  • Mt Pleasant, SC
National Provider Identifier
1467734608
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3679 Issued in SC
Practice address
874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901
Phone
(843) 400-4087
Fax
(843) 636-5689
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3679 SC Primary

Addresses

Primary practice location

874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901

Mailing address

874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901
Phone (843) 400-4087

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000219 SC Practitioner - Chiropractic 4082838388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

767 Coleman Blvd
Suite 2
Mount Pleasant, SC 29464-4035
Phone (843) 416-8012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3679SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Chiropractic LLC Chiropractor CurrentSince Mar 18, 2014 Accepting new patients

Locations

874 Whipple Rd
Ste 200
Mt Pleasant, SC 29464
Phone (843) 277-6600

767 Coleman Blvd
Ste 2
Mt Pleasant, SC 29464
Phone (843) 416-8012

Organizations & group practices 1

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1467734608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 WHIPPLE ROAD",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648901",
            "telephone_number": "843-400-4087",
            "fax_number": "843-636-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 WHIPPLE ROAD",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648901",
            "telephone_number": "843-400-4087",
            "fax_number": "843-636-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JODI",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.