Individual provider Active NPI

Kathryn Kennedy, DC

  • Chiropractor
  • South Burlington, VT
National Provider Identifier
1881304764
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006.0134183 Issued in VT
Practice address
185 Tilley Dr Ste 57
South Burlington, VT 05403-4484
Phone
(802) 879-1703
NPI assigned
Dec 1, 2022
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006.0134183 VT Primary

Addresses

Primary practice location

185 Tilley Dr Ste 57
South Burlington, VT 05403-4484

Mailing address

185 Tilley Dr Ste 57
South Burlington, VT 05403-4484
Phone (802) 879-1703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228002721 VT Practitioner - Chiropractic 1658741012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back and Neck CenterGroup PAC ID 4183791247, 2 clinicians

Practice addresses (Care Compare)

185 Tilley Dr
Suite 57
South Burlington, VT 05403-4484
Phone (802) 879-1703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006.0134183VTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Maitri Health Care for Women PC CurrentSince Dec 6, 2022 Accepting new patients
Back and Neck Center Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

185 Tilley Dr
Ste 57
South Burlington, VT 05403
Phone (802) 233-6692

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACAHCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1881304764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 TILLEY DR STE 57",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034484",
            "telephone_number": "802-879-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TILLEY DR STE 57",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034484",
            "telephone_number": "802-879-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHRYN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0134183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.

Verify at the official NPI Registry.