Sara Kennedy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004077 Issued in NC

Practice address

725 Highland Ave
2ND Floor
Winston Salem, NC 27101-4206

Phone

(336) 607-8501

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700801495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 ELKMONT CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129717",
            "telephone_number": "336-607-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HIGHLAND AVE",
            "address_2": "2ND FLOOR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014206",
            "telephone_number": "336-607-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003320",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanine Rivituso Kennedy, R.D., L.D.N.
• Leanne Davidson Kennedy, PHARMD
• Maria Basilio Kennedy, PTA
• Michael Elizabeth Kennedy, ANP, AG-ACNP
• Michael S Kennedy, R.PH.
• Kenneth M. Sadler DDS & Associates, PA
• Kenneth R,. Russell, D.D.S. PA
• Lindsay Anne Kenney, BSN, MSN, CRNA
• Lauren Kennon
• John Kensinger, PA-C

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.