Tracy Elizabeth Kennedy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17226 Issued in FL

Practice address

5664 SW 60TH Ave
Ocala, FL 34474-5677

Phone

(352) 291-5555

Fax

(352) 291-5582

NPI assigned

Jul 15, 2020

Last updated

Oct 8, 2020By the provider in NPPES

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD (past)

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1942818018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BAHIA PASS PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344728291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5664 SW 60TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745677",
            "telephone_number": "352-291-5555",
            "fax_number": "352-291-5582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Bahia Pass Pl",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344728291",
            "country_code": "US",
            "telephone_number": "860-836-2460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TRACY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Nathan Kendall, MD
• Christie Elaine Kennedy, DNP
• Elsia Lee Kennedy, CRNA
• Mary Kennedy, OTR/L
• Sarah A Kennedy, O.D
• Laura M. Kent-Hilgenfeldt, PA-C
• Lee Anne Keough, DMD, MS
• Keren's Afch LLC
• Keren's Caring Heart LLC
• Susan F Kerns, M.D.

• Clinical Social Worker in Ocala, FL
• Providers in Ocala, FL by specialty
• Clinical Social Worker in Florida

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