Mary Eleanor Kennedy, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5502001417 Issued in MI

Practice address

5211 Marsh Rd
Okemos, MI 48864-1106

Phone

(517) 319-1400

NPI assigned

Mar 2, 2011

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

State licenses

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1891093761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 MARSH RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 MARSH RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641106",
            "telephone_number": "517-319-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARY",
        "middle_name": "ELEANOR",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5502001417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Thomas LLC
• Ralph Michael Kelly, M.D.
• Hannah Elizabeth Kempl
• Rebeka Kendrick, COTA
• John Kennedy
• Justin Kent
• Jacob Kerckaert
• Elisabeth Kern, M.A.
• Padmaja Ketineni
• Annika Kettunen

• Physical Medicine & Rehabilitation Physician in Okemos, MI
• Providers in Okemos, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.