Kendelyn Jade Eddy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002002 Issued in WV

Practice address

12 Rousch Dr
Westover, WV 26501-3872

Phone

(304) 598-6099

NPI assigned

Nov 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1992415970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ROUSCH DR",
            "city": "WESTOVER",
            "state": "WV",
            "postal_code": "265013872",
            "telephone_number": "304-598-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ROUSCH DR",
            "city": "WESTOVER",
            "state": "WV",
            "postal_code": "265013872",
            "telephone_number": "304-598-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "KENDELYN",
        "middle_name": "JADE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "002002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kendelyn.eddy@wvumedicine.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "12 Rousch Dr",
            "city": "Westover",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265013872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapy Assistant in Westover, WV
• Providers in Westover, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.