Active NPI
Stacie Dawn Kennard, OTR/L
- Occupational Therapist
- Portsmouth, OH
National Provider Identifier
1639275498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-6494
- Practice address
- 2125 Royce St
Portsmouth, OH 45662-4714 - Phone
- (740) 876-9232
- Fax
- (740) 876-9525
- NPI assigned
- Sep 16, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-6494 | OH | Primary |
Addresses
Primary practice location
2125 Royce St
Portsmouth, OH 45662-4714
Mailing address
825 Dorrene Dr
Wheelersburg, OH 45694-1824
Phone (740) 574-2436
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 |
|---|---|---|---|
| OT-6494 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248825600000",
"number": "1639275498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 DORRENE DR",
"city": "WHEELERSBURG",
"state": "OH",
"postal_code": "456941824",
"telephone_number": "740-574-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 ROYCE ST",
"city": "PORTSMOUTH",
"state": "OH",
"postal_code": "456624714",
"telephone_number": "740-876-9232",
"fax_number": "740-876-9525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNARD",
"first_name": "STACIE",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2009-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT-6494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.