Active NPI
Connie Marie Kedzierski, MPT
- Geriatric Physical Therapist
- Jeannette, PA
National Provider Identifier
1851504229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- PT009176L
- Practice address
- 2030 Ader Rd
Jeannette, PA 15644-4500 - Phone
- (724) 327-3557
- NPI assigned
- May 8, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | PT009176L | PA | Primary |
Addresses
Primary practice location
2030 Ader Rd
Jeannette, PA 15644-4500
Mailing address
144 Carmella Dr
Irwin, PA 15642-8911
Phone (724) 744-4979
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009176L | PA | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851504229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 CARMELLA DR",
"city": "IRWIN",
"state": "PA",
"postal_code": "156428911",
"telephone_number": "724-744-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 ADER RD",
"city": "JEANNETTE",
"state": "PA",
"postal_code": "156444500",
"telephone_number": "724-327-3557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEDZIERSKI",
"first_name": "CONNIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "PA",
"license": "PT009176L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jeannette, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.