Jelani Hennessey

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306604870 Issued in VA

Practice address

3600 Woods Way
State Farm, VA 23160-0002

Phone

(804) 598-4251

NPI assigned

Nov 1, 2018

Last updated

May 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1891262309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 AFTON AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232247902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 WOODS WAY",
            "city": "STATE FARM",
            "state": "VA",
            "postal_code": "231600002",
            "telephone_number": "804-598-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "JELANI",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50520",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "5069",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akinyele Lawrence Akinyoola, MD
• Mark Steven Amonette, M.D.
• Alan Jay Arikian, M.D.
• Mary Evadne Clarke, M.D.
• Stephanie Ann Heath, FNP
• Karen Isaacs, RDH
• Bruce Stanley Janek, D.M.D.
• Elizabeth Lee, DMD
• Robyn Leigh Saavedra, A PRN-BC FNP

• Physical Therapy Assistant in State Farm, VA
• Providers in State Farm, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.