Justin Dwayne Kennemer, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OTR2937 Issued in AR

Practice address

385 Highway 65 N
Conway, AR 72032-3506

Phone

(501) 697-9881

NPI assigned

Nov 12, 2018

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kennemetrics LLC

  dba Therapy Monkey

  • Occupational Therapist
  • Conway, AR
  • NPI 1124781729
  NPD Authorized official
• KNM Therapy LLC

  dba Therapy Monkey @ SCCH

  • Occupational Therapist
  • Morrilton, AR
  • NPI 1699412007
  NPD Authorized official

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1578031282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 S BOLDEN HILL RD",
            "city": "GREENBRIER",
            "state": "AR",
            "postal_code": "720589024",
            "telephone_number": "817-688-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 HIGHWAY 65 N",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720323506",
            "telephone_number": "501-697-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEMER",
        "first_name": "JUSTIN",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-12",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OTR2937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Kennedy, M.D.
• Heather Parker Kennedy, A.T.C.
• Kaitlin E Kennedy, BT
• Kristy R Kennedy, MSW
• Erica Kennemer, OTR/L, MOT, HPCS
• Kennemetrics LLC (Therapy Monkey)
• Sheffield Kent, M.D.
• Christopher Kershner, DC
• Trina Kervin, MS CCC-SLP
• Christoni Key

• Pediatric Occupational Therapist in Conway, AR
• Providers in Conway, AR by specialty
• Pediatric Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.