Active NPI
Colleen H Kennedy, PT
- Geriatric Physical Therapist
- Chelsea, MA
National Provider Identifier
1649571753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 4317
- Practice address
- 1000 Broadway
Chelsea, MA 02150-2247 - Phone
- (617) 660-6402
- NPI assigned
- Nov 4, 2010
- Last updated
- Nov 4, 2010
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 4317 | MA | Primary |
Addresses
Primary practice location
1000 Broadway
Chelsea, MA 02150-2247
Mailing address
1000 Broadway
Chelsea, MA 02150-2247
Phone (617) 660-6402
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4317 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1649571753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BROADWAY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021502247",
"telephone_number": "617-660-6402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BROADWAY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021502247",
"telephone_number": "617-660-6402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "COLLEEN",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-04",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "MA",
"license": "4317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.