Active NPI
Rebecca Jill Kennedy, DPT
- Physical Therapist
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21118
- Practice address
- 484 Main St
Worcester, MA 01608-1893 - Phone
- (800) 244-2756
- Fax
- (508) 831-9768
- NPI assigned
- Dec 3, 2014
- 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 | 21118 | MA | Primary |
Addresses
Primary practice location
484 Main St
Worcester, MA 01608-1893
Mailing address
33 E Chestnut St
Apartment 2
Sharon, MA 02067-2032
Phone (616) 745-4957
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21118 | Other | MA PHYSICAL THERAPY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
245 Cherry St SE
Suite 102
Grand Rapids, MI 49503-4607
Phone (616) 201-3909
3686 32ND Ave
Suite 400
Hudsonville, MI 49426-8546
Phone (616) 377-1010
4085 Burton St SE
Suite 100
Grand Rapids, MI 49546-2444
Phone (616) 233-3599
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21118 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advent Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
| Advent Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
Locations
6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014
245 Cherry St SE
Ste 102
Grand Rapids, MI 49503
Phone (616) 201-3909
933 3 Mile Rd NW
Ste 104
Grand Rapids, MI 49544
Phone (616) 233-3592
4085 Burton St SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 233-3599
625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
3380 44th St SW
Grandville, MI 49418
Phone (616) 685-8250
Organizations & group practices 2
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.
-
- Physical Therapist
- Grand Rapids, MI
- NPI 1780639658
-
- Physical Therapist
- Grand Rapids, MI
- NPI 1437923729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1770980955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 E CHESTNUT ST",
"address_2": "APARTMENT 2",
"city": "SHARON",
"state": "MA",
"postal_code": "020672032",
"telephone_number": "616-745-4957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081893",
"telephone_number": "800-244-2756",
"fax_number": "508-831-9768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "REBECCA",
"middle_name": "JILL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-03",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "21118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA PHYSICAL THERAPY LICENSE",
"identifier": "21118",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.