Callaway Kennedy, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

25556 Issued in CA

Practice address

11205 Knott Ave Ste E
Cypress, CA 90630-5489

Phone

(714) 893-7399

NPI assigned

Oct 25, 2023

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

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

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Rise Physical Therapy IncGroup PAC ID 2062636079, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rise Physical Therapy Inc

  dba SoCal Elite Physical Therapy

  • Physical Therapy Clinic/Center
  • Solana Beach, CA
  • NPI 1083038764
  Medicare reassignment Care Compare group NPD
• Orthopaedic and Neurological Rehab Inc

  • Rehabilitation Clinic/Center
  • Billings, MT
  • NPI 1225496540

  CA

  Medicare reassignment
• South Coast Pediatric Physical Therapy, Inc

  • Speech-Language Pathologist
  • Cypress, CA
  • NPI 1467604694
  NPD

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1639941479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 KNOTT AVE STE E",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 KNOTT AVE STE E",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305489",
            "telephone_number": "714-893-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CALLAWAY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "25556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minji Hailey Kang
• Youngmo Kang, DDS
• Karing Physicians Medical Group, Inc.
• Katsuko Matsui Inc. a Professional Dental Cooperation
• Caitlin Alexa Kelliher
• Ramtin Khaef, DMD
• Kenny Khuu, PHARMD, RPH
• Vy Kieu, NP
• Chaewon Kim
• Christopher Sungbum Kim, D.C.

• Occupational Therapist in Cypress, CA
• Providers in Cypress, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.