Sean Mitchell Kennedy, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

929 Boston Post Rd
Old Saybrook, CT 06475-2143

Phone

(860) 388-6511

Fax

(860) 395-0016

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487673133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 DAMON HEIGHTS RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571540",
            "telephone_number": "860-235-3789",
            "fax_number": "860-395-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752143",
            "telephone_number": "860-388-6511",
            "fax_number": "860-395-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SEAN",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen E Kapij, LCSW, LMSW, MSW
• Karl E Scheibe
• Kathleen C. Laundy Associates, LLC
• Ethan A. Kelly, MSW
• Kennedy & Perkins. Inc.
• Armen G Ketchedjian, MD
• David Fisher Kimble, RN CNS
• King Family Eye Care, LLC
• Matthew Stephen King, O.D.
• KNM Enterprises LLC

• Athletic Trainer in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.