Connor Kennedy, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21053 Issued in NC

Practice address

9216 Ardrey Kell Rd Ste 300
Charlotte, NC 28277-4954

Phone

(980) 556-7330

Fax

(980) 939-8215

NPI assigned

Mar 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1912656398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 ARDREY KELL RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774954",
            "telephone_number": "980-556-7330",
            "fax_number": "980-939-8215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Crisanto Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297156272",
            "country_code": "US",
            "telephone_number": "803-746-4655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CONNOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11608",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Douglas Kennedy, D.D.S
• Beth Ann Kennedy, LPC
• Bonnie M Kennedy, C.R.N.A.
• Carrie Frasure Kennedy, FNP
• Cindy Sutton Kennedy, RPH
• Danielle E Kennedy
• Darin Neal Kennedy, MD
• Deja Neayette Kennedy
• Erica Kennedy
• Holly M Kennedy, PT

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.