Physician Compare National (NPI:1851490510)

HEALTHCARE PROVIDER: AUDREY J KENNEDY PHYSICAL THERAPIST

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1851490510
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769632074
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121023000322
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KENNEDY
	Individual professional last name
Provider First Name	AUDREY
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY, ARIZONA SCHOOL OF DENTISTRY & ORAL HLTH
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	1ST CHOICE PT, LLC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7315197613
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1533 MEMORIAL DR
	Group Practice or individual's line 1 address
City	OAKLAND
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	215504338
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3016162919
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y