Active NPI
Vanneta K Kennedy, PT, DPT
- Physical Therapist
- Ashland, VA
National Provider Identifier
1568423549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204413
- Practice address
- 10640 Charter Hill CT
Suite 102
Ashland, VA 23005-7749 - Phone
- (804) 550-5730
- Fax
- (804) 550-5733
- NPI assigned
- Mar 30, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305204413 | VA | Primary |
Addresses
Primary practice location
10640 Charter Hill CT
Suite 102
Ashland, VA 23005-7749
Mailing address
771 Pilot House Dr
Newport News, VA 23606
Phone (757) 873-2302
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00245786 | Other | VA | RAILROAD MEDICARE |
| 010192153 | Medicaid | VA | |
| 192931 | Other | VA | BCBS PHYSICAL THERAPY |
| 7867723 | Other | AETNA |
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 |
|---|---|---|---|
| 2305204413 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357689600000",
"number": "1568423549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 PILOT HOUSE DR",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "23606",
"telephone_number": "757-873-2302",
"fax_number": "757-873-2306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10640 CHARTER HILL CT",
"address_2": "SUITE 102",
"city": "ASHLAND",
"state": "VA",
"postal_code": "230057749",
"telephone_number": "804-550-5730",
"fax_number": "804-550-5733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "VANNETA",
"middle_name": "K",
"name_prefix": "Miss",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-30",
"last_updated": "2013-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204413",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00245786",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010192153",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PHYSICAL THERAPY",
"identifier": "192931",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7867723",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.