Active NPI
Daniel Kennedy, MOTR/L
- Occupational Therapist
- Kansas City, MO
National Provider Identifier
1629512900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1702908
- Practice address
- 8559 N Line Creek Pkwy
Kansas City, MO 64154-2100 - Phone
- (816) 468-2011
- NPI assigned
- Dec 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1702908 | KS | Primary |
| Occupational Therapist | 225X00000X | 2010022884 | MO |
Addresses
Primary practice location
8559 N Line Creek Pkwy
Kansas City, MO 64154-2100
Mailing address
4104 NE Shady Lane Dr
Gladstone, MO 64119-5019
Phone (785) 383-3018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010022884 | MO | MD | Occupational Therapist |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Mission, KS
- NPI 1679617955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1629512900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4104 NE SHADY LANE DR",
"city": "GLADSTONE",
"state": "MO",
"postal_code": "641195019",
"telephone_number": "785-383-3018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8559 N LINE CREEK PKWY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641542100",
"telephone_number": "816-468-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "MOTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-06",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "1702908",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2010022884",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.