Jamira Antoinette Kennedy

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

78113601 Issued in PA

Practice address

1137 S Ruby St
Philadelphia, PA 19143-4822

Phone

(267) 671-0218

NPI assigned

Apr 27, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Miracle Hands Home Care LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
  • NPI 1730916636

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1714176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1518713874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 S RUBY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191434822",
            "telephone_number": "267-671-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 S RUBY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191434822",
            "telephone_number": "267-671-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JAMIRA",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-27",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "PA",
            "license": "78113601",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "PA",
            "license": "78113601",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "78113601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David William Kennedy, MD
• Dearlo Kennedy, CLINICAL DIRECTOR
• Dhameer Kennedy, BEHAVIOR TECHNICIAN
• Erin Kennedy, OTR/L
• Eugene P. Kennedy, M.D.
• Jennifer Kennedy, D.O.
• Jill Kennedy
• Jordan Kennedy, MD
• Julia Kennedy, D.O.
• Kaitlin Kennedy, DMD

• In Home Supportive Care Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; 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.