Active NPI
June Kennedy, PT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1710113451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3484
- Practice address
- 1108 Dresser CT
Suinte 201B
Raleigh, NC 27609-7328 - Phone
- (919) 876-8302
- Fax
- (919) 954-8706
- NPI assigned
- Jun 9, 2009
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3484 | NC | Primary |
Addresses
Primary practice location
1108 Dresser CT
Suinte 201B
Raleigh, NC 27609-7328
Mailing address
1108 Dresser CT
Suinte 201B
Raleigh, NC 27609-7328
Phone (919) 876-8302
Other names 1
- June E St. Romain
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090724000607 | NC | Practitioner - Physical Therapist in Private Practice | 5890848733 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1710113451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 DRESSER CT",
"address_2": "SUINTE 201B",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097328",
"telephone_number": "919-876-8302",
"fax_number": "919-954-8706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 DRESSER CT",
"address_2": "SUINTE 201B",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097328",
"telephone_number": "919-876-8302",
"fax_number": "919-954-8706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JUNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "3484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUNE",
"last_name": "ST. ROMAIN",
"middle_name": "E",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.