Individual provider Active NPI

Shay Kennedy, DPT

  • Physical Therapist
  • Murray, UT
National Provider Identifier
1902262462
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9434815-2401 Issued in UT
Practice address
5121 S Cottonwood St
Murray, UT 84107-5701
Phone
(801) 507-7000
NPI assigned
Jan 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9434815-2401 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St
Murray, UT 84107-5701

Mailing address

10428 S Jordan Gtwy Unit 324
South Jordan, UT 84095-5404

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

LicenseStateTypeSpecialty
9434815-2401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1902262462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10428 S JORDAN GTWY UNIT 324",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SHAY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "9434815-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.