Justine Kenny, MS, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT009013 Issued in GA

Practice address

130 N Gross Rd Ste 125
Kingsland, GA 31548-6263

Phone

(912) 342-8875

Fax

(912) 342-8016

NPI assigned

Jan 12, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Pediatric Therapies of SE Ga, LLC

  • Pediatric Occupational Therapist
  • Brunswick, GA
  • NPI 1841577111

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1740051226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203016",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N GROSS RD STE 125",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486263",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "JUSTINE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT009013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Edward Jones Jr., PTA
• Courtney Joseph
• Rosemarie Panides Kaiser, LCSW
• Allan I Kart, RPH
• Anna Kennedy, MS, LMHC, LPC, NCC
• William Mansfield Keyser, LCSW
• Kristi Kindell
• Darrell Maurice Lampkin, PHARM.D.
• Rachel Valerie Lane, OT
• Georgia Star Lantz, CPHT

• Pediatric Occupational Therapist in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.