Active NPI
Nancy Kennedy East
- Physical Therapist
- Roswell, GA
National Provider Identifier
1598493983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016083
- Practice address
- 12050 Etris Rd
Roswell, GA 30075-1443 - Phone
- (770) 801-4657
- NPI assigned
- Aug 12, 2022
- 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 | PT016083 | GA | Primary |
Addresses
Primary practice location
12050 Etris Rd
Roswell, GA 30075-1443
Mailing address
325 Woodland Way
Dublin, GA 31021-0365
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016083 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1598493983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 WOODLAND WAY",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310210365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12050 ETRIS RD",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300751443",
"telephone_number": "770-801-4657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAST",
"first_name": "NANCY",
"middle_name": "KENNEDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-12",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT016083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
- Dynasty Dental Care Inc.
- E M S Ventures Inc (Rural Metro Ambulance)
- Joel A Eaby, DPT
- Early Connections Child & Family Counseling, LLC
- Lynn Marie Earman
- Adrien Caylin Easterwood, BCBA
- Robert Murphy Eberbaugh, D.D.S.
- Ec Roswell Operations, LLC (Elmcroft of Roswell)
- Angela Christine Edgar, RN, BSN, CCRN, CMC
- Edge Treatment LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.