Active NPI
Judith Eileen Kennedy
- Occupational Therapist
- Miamisburg, OH
National Provider Identifier
1669942603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 05662
- Practice address
- 1120 Dunaway St
Miamisburg, OH 45342-3839 - Phone
- (937) 866-9089
- NPI assigned
- Dec 3, 2018
- 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 | 05662 | OH | Primary |
Addresses
Primary practice location
1120 Dunaway St
Miamisburg, OH 45342-3839
Mailing address
10051 Yearling Run S
Dayton, OH 45458-5049
Phone (937) 623-0806
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 |
|---|---|---|---|
| 05662 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1669942603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10051 YEARLING RUN S",
"city": "DAYTON",
"state": "OH",
"postal_code": "454585049",
"telephone_number": "937-623-0806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 DUNAWAY ST",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423839",
"telephone_number": "937-866-9089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JUDITH",
"middle_name": "EILEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-03",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "05662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.