Individual provider Active NPI

Jodi L Kennedy, D.C.

  • Rehabilitation Chiropractor
  • Mahopac, NY
National Provider Identifier
1679784649
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
X010574-1 Issued in NY
Practice address
11 Miller Rd
Mahopac, NY 10541-2219
Phone
(845) 628-7233
Fax
(845) 628-4549
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010574-1 NY
Nutrition Chiropractor 111NN1001X X010574-1 NY
Rehabilitation Chiropractor 111NR0400X X010574-1 NY Primary

Addresses

Primary practice location

11 Miller Rd
Mahopac, NY 10541-2219

Mailing address

11 Miller Rd
Mahopac, NY 10541-2219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070814000474 NY Practitioner - Chiropractic 7214028653 Practice locations: Mahopac, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11 Miller Rd
Mahopac, NY 10541-2219
Phone (845) 628-7233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010574-1NYMDNutrition Chiropractor
010574NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott a. Croce DC PC Chiropractor PastSince May 1, 2002 Accepting new patients
Buffalo Family Chiropractic Wellness, P.C. Chiropractor PastSince Jan 1, 2015 Accepting new patients

Organizations & group practices 2

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679784649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MILLER RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MILLER RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412219",
            "telephone_number": "845-628-7233",
            "fax_number": "845-628-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JODI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010574-1",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X010574-1",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "X010574-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.