Active NPI
Carol J Kennedy, PT
- Physical Therapist
- Seattle, WA
National Provider Identifier
1497899629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00003396
- Practice address
- 937 NW 96TH St
Seattle, WA 98117-2244 - Phone
- (206) 789-6099
- Fax
- (206) 789-3323
- NPI assigned
- Feb 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00003396 | WA | Primary |
Addresses
Primary practice location
937 NW 96TH St
Seattle, WA 98117-2244
Mailing address
937 NW 96TH St
Seattle, WA 98117-2244
Phone (206) 789-6099
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT00003396 | Other | WA | PT LICENSE # |
| KE5476 | Other | WA | REGENCE INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00003396 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497899629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 NW 96TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981172244",
"telephone_number": "206-789-6099",
"fax_number": "206-789-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "937 NW 96TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981172244",
"telephone_number": "206-789-6099",
"fax_number": "206-789-3323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "CAROL",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003396",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE #",
"identifier": "PT00003396",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE INSURANCE",
"identifier": "KE5476",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- 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.