Kennedy Ndamba, DPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

23384 Issued in MA

Practice address

1242 River St
Hyde Park, MA 02136-2833

Phone

(978) 390-6996

Fax

(857) 345-9591

NPI assigned

Jan 10, 2019

Last updated

Jul 24, 2023By the provider in NPPES

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

Enrolled in MA

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Keka Services, Inc

  • Geriatric Physical Therapist
  • Hyde Park, MA
  • NPI 1790473528

  Geriatrics

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1518430651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 RIVER ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362833",
            "telephone_number": "978-390-6996",
            "fax_number": "857-345-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 RIVER ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362833",
            "telephone_number": "978-390-6996",
            "fax_number": "857-345-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDAMBA",
        "first_name": "KENNEDY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-10",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MA",
            "license": "23384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comfort Muyide, RN, MSN
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• Robert Frederick Nace, PSY.D., M.DIV.
• Genesis Naveira
• Ndidi Ndukwe-Uga, LPN
• Nextchapter
• Henry Nguyen, OD
• Nicholas and Mattie Center for the Homeless
• Veronica Nielsen-Vilar

• Geriatric Physical Therapist in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Geriatric Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.