Mia M Kennedy, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104555747 Issued in VA

Practice address

1461 W Main St
Salem, VA 24153-3120

Phone

(540) 375-9220

Fax

(540) 375-9229

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John a Morris DC PAGroup PAC ID 3870750979, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• John a Morris DC PA

  • Chiropractor
  • Jacksonville Beach, FL
  • NPI 1588779235
  Medicare reassignment Care Compare group NPD
• Mkkinetics LLC

  • Health Service Clinic/Center
  • Jacksonville, FL
  • NPI 1801742572
  NPD Authorized official
• Performance Physical Medicine and Rehab

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville Beach, FL
  • NPI 1720456254
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1508935362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533120",
            "telephone_number": "540-375-9220",
            "fax_number": "540-375-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533120",
            "telephone_number": "540-375-9220",
            "fax_number": "540-375-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "350669",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty Rose Kelley
• Michael Thomas Kelly, D.O.
• James C Kemper, DDS
• Kennedy Chiropractic Inc.
• Jordan Kennedy, LPC
• Patrick Kennedy
• Patrick D Kennedy, DC
• Priscilla Kennedy, DO
• Allen Reif Kessler II, M.D.
• Katharina Keys, CTRS

• Chiropractor in Salem, VA
• Providers in Salem, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.