Individual provider Active NPI

Kyle Kennedy, DPT

  • Physical Therapy Clinic/Center
  • Rock Hill, SC
National Provider Identifier
1750794806
Registry record updated Nov 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
8542 Issued in SC
Practice address
226 Northpark Dr
Rock Hill, SC 29730-4292
Phone
(803) 327-8874
NPI assigned
Jun 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 037720 NY
Physical Therapy Clinic/Center 261QP2000X 8542 SC Primary

Addresses

Primary practice location

226 Northpark Dr
Rock Hill, SC 29730-4292

Mailing address

214 Butterfly PL
Fort Mill, SC 29708-0138
Phone (845) 926-8733

Other practice location 1

13 Lexington Dr
Newburgh, NY 12550-1293
Phone (845) 926-8733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8542SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669420800000",
    "number": "1750794806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BUTTERFLY PL",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297080138",
            "telephone_number": "845-926-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 NORTHPARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304292",
            "telephone_number": "803-327-8874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Lexington Dr",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125501293",
            "country_code": "US",
            "telephone_number": "845-926-8733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KYLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-11-26",
        "certification_date": "2022-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037720",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "SC",
            "license": "8542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2022; 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.