Active NPI
Shelly C. Kennedy, D.C.
- Chiropractor
- Sarasota, FL
National Provider Identifier
1508852989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH0006233
- Practice address
- 4155 Clark Rd
Sarasota, FL 34233-2403 - Phone
- (941) 929-0020
- Fax
- (941) 921-7843
- NPI assigned
- Sep 21, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH0006233 | FL | Primary |
Addresses
Primary practice location
4155 Clark Rd
Sarasota, FL 34233-2403
Mailing address
4155 Clark Rd
Sarasota, FL 34233-2403
Phone (941) 929-0020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22563 | Other | FL | BCBS |
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 |
|---|---|---|---|
| CH0006233 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361491200000",
"number": "1508852989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4155 CLARK RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342332403",
"telephone_number": "941-929-0020",
"fax_number": "941-921-7843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4155 CLARK RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342332403",
"telephone_number": "941-929-0020",
"fax_number": "941-921-7843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "SHELLY",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-21",
"last_updated": "2013-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH0006233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "22563",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.