Individual provider Active NPI

Joan Margaret Kennedy, P.T.

  • Physical Therapist
  • Leesburg, VA
National Provider Identifier
1972621068
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305202642 Issued in VA
Practice address
224D Cornwall St NW
Suite 200
Leesburg, VA 20176-2700
Phone
(703) 443-2223
Fax
(703) 443-2690
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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 2305202642 VA Primary

Addresses

Primary practice location

224D Cornwall St NW
Suite 200
Leesburg, VA 20176-2700

Mailing address

PO Box 17334
Baltimore, MD 21297-1334
Phone (703) 443-6717

Other identifiers 2

IdentifierTypeStateIssuer
1972621068MedicaidVA
P00948393OtherVARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080605000272 VA Practitioner - Physical Therapist in Private Practice 6709956576 Reassigns benefits to 1 organization
I20200325002010 DC Practitioner - Physical Therapist in Private Practice 6709956576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

7 Clyde Rd
Somerset, NJ 08873-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305202642VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1972621068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW",
            "address_2": "SUITE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762700",
            "telephone_number": "703-443-2223",
            "fax_number": "703-443-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOAN",
        "middle_name": "MARGARET",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972621068",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00948393",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.