NPIMap

Organization Active NPI

Kennedy Chiropractic Clinic, Inc

  • Chiropractor
  • Sarasota, FL
National Provider Identifier
1932415130
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006233 Issued in FL
Legal business name
KENNEDY CHIROPRACTIC CLINIC, INC
Practice address
4155 Clark Rd
Sarasota, FL 34233-2403
Phone
(941) 929-0020
Fax
(941) 921-7843
NPI assigned
Aug 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Authorized official

Name
Dr. Shelly Kennedy, D.C.NPI 1508852989
Title
Owner/ Chiropractic Physician
Phone
(941) 929-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0006233 FL Primary

Addresses

Primary practice location

4155 Clark Rd
Sarasota, FL 34233-2403

Mailing address

4155 Clark Rd
Sarasota, FL 34233-2403
Phone (941) 929-0020

Other identifiers 1

IdentifierTypeStateIssuer
22563OtherFLMEDICARE PTAN / BCBS PROVIDER #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1932415130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332403",
            "telephone_number": "941-929-0020",
            "fax_number": "941-921-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332403",
            "telephone_number": "941-929-0020",
            "fax_number": "941-921-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "941-929-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN / BCBS PROVIDER #",
            "identifier": "22563",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.