NPI Code Detail JSON Logo

1205058005 NPI number — JENNIFER KEMP PT

NPI Number: 1205058005
Health Care Provider/Practitioner: JENNIFER KEMP PT

Information about “1205058005” NPI (JENNIFER KEMP PT) exists in 1205058005 in HTML format HTML  |  1205058005 in plain Text format TXT  |  1205058005 in PDF (Portable Document Format) PDF  |  1205058005 in an XML format XML  formats.

NPI Number : 1205058005 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205058005",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KEMP",
    "FirstName": "JENNIFER",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3010 PENN FOREST BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROANOKE",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "24018-4307",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-443-2319",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17507 LEE HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ABINGDON",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "24210-7835",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "276-525-6043",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/02/2007",
    "LastUpdateDate": "01/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2251P0200X",
        "TaxonomyName": "Pediatric Physical Therapist",
        "LicenseNumber": "2305203509",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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