Organization Active NPI

Kennedy Chiropractic LLC

  • Chiropractor
  • Mount Pleasant, SC
National Provider Identifier
1730522095
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3679 Issued in SC
Legal business name
KENNEDY CHIROPRACTIC LLC
Practice address
874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901
Phone
(843) 400-4087
Fax
(843) 636-5689
NPI assigned
Apr 16, 2013
Last updated
Oct 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Authorized official

Name
Dr. Jodi Kennedy, DCNPI 1467734608
Title
President/Sole MBR
Phone
(843) 400-4087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3679 SC Primary

Addresses

Primary practice location

874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901

Mailing address

874 Whipple Road
Suite 200
Mt Pleasant, SC 29464-8901
Phone (843) 400-4087

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140606000126 SC Part B Supplier - Clinic/Group Practice 3173747474 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Locations

767 Coleman Blvd
Ste 2
Mt Pleasant, SC 29464
Phone (843) 416-8012

874 Whipple Rd
Ste 200
Mt Pleasant, SC 29464
Phone (843) 277-6600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1730522095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 WHIPPLE ROAD",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648901",
            "telephone_number": "843-400-4087",
            "fax_number": "843-636-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 WHIPPLE ROAD",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648901",
            "telephone_number": "843-400-4087",
            "fax_number": "843-636-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "PRESIDENT/SOLE MBR",
        "authorized_official_telephone_number": "843-400-4087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.

Verify at the official NPI Registry.