Individual provider Active NPI

Kennedi Riley

  • Physical Therapist
  • Randallstown, MD
National Provider Identifier
1629894472
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30198 Issued in MD
Practice address
8511 Liberty Rd Ste BB
Randallstown, MD 21133-4837
Phone
(443) 426-9100
Fax
(410) 922-0679
NPI assigned
Nov 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 30198 MD Primary

Addresses

Primary practice location

8511 Liberty Rd Ste BB
Randallstown, MD 21133-4837

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-0000

Other practice location 1

10700 Charter Dr Ste 205
Columbia, MD 21044-3687
Phone (443) 997-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216000399 MD Practitioner - Physical Therapist in Private Practice 2961938881 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

10700 Charter Dr
Columbia, MD 21044-3687

10803 Falls Rd
Suite 2100
Lutherville, MD 21093-4562
Phone (410) 367-3307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30198MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 3, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 3, 2024 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Jun 1, 2025 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Jun 1, 2025 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

10700 Charter Dr
Ste 205
Columbia, MD 21044
Phone (443) 546-1575

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

8511 Liberty Rd
Ste Bb
Randallstown, MD 21133
Phone (443) 426-9100

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1629894472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 LIBERTY RD STE BB",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334837",
            "telephone_number": "443-426-9100",
            "fax_number": "410-922-0679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Charter Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443687",
            "country_code": "US",
            "telephone_number": "443-997-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "KENNEDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.