CHARLES J KENNEDY (NPI# 1528260130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528260130 |
| Entity Type | Individual |
| Full Name | CHARLES J KENNEDY |
| Credential | PHD |
| Practice Address |
214 College Park Plz Johnstown PA 15904-2833 |
| Practice Telephone | 8142620025 |
| Practice Fax Number | 8142668745 |
| Mailing Telephone | 8142620025 |
| Mailing Fax Number | 8142668745 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS015731 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1014900430001 | 05 | |
| PA | HIGHMARK | 1796076 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124455985 | Charles Kennedy Jr. | Specialist | 8454 Northview Pass, Fair Oak Ranch, TX 78015 | 2013-10-10 |
| 1942576111 | Charles Derensbough Kennedy | Internal Medicine | 229 Sycamore Grove St, Simi Valley, CA 93065-7342 | 2012-03-31 |
| 1902981624 | Charles A Kennedy | Social Worker | 4120 N 20th St Ste B, Phoenix, AZ 85016-6022 | 2006-10-25 |
| 1750485116 | Charles Reed Kennedy | Psychologist | 112 Holland Ave, Albany, NY 12208-3404 | 2006-09-07 |
| 1124477708 | Charles Kennedy | Student in an Organized Health Care Education/Training Program | 500 Cherry St, Bluefield, WV 24701-3306 | 2016-06-06 |
| 1467824425 | Charles T. Kennedy Jr. | Social Worker | 1309 S Linden Rd Ste C, Flint, MI 48532-3443 | 2015-10-29 |
| 1548583172 | Charles Reggie Kennedy Sr. | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-03-10 |
| 1730320805 | Charles M Kennedy | Counselor | 171 Sw Court St, Dallas, OR 97338-3112 | 2009-03-18 |
| 1790896199 | Charles A. Kennedy | Dentist | 1000 Parkway Rd, South Charleston, WV 25309-9418 | 2006-08-31 |
| 1912984428 | Charles C Kennedy | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-27 |
| Street Address |
214 COLLEGE PARK PLZ |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15904-2833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073573010 | Nulton Diagnostic & Treatment Center, PC | Community/Behavioral Health | 214 College Park Plz, Johnstown, PA 15904-2833 | 2006-03-24 |
| 1710519269 | Gemma Elizabeth Rusnak | Social Worker | 214 College Park Plz, Johnstown, PA 15904-2833 | 2020-02-12 |
| 1073070231 | Janelle Marie Flook | Behavior Technician | 214 College Park Plz, Johnstown, PA 15904-2833 | 2019-02-25 |
| 1790258986 | Sarah Lynette Fisher | Registered Nurse | 214 College Park Plz, Johnstown, PA 15904-2833 | 2019-01-10 |
| 1780152637 | Alisha Mae Blough | Registered Nurse | 214 College Park Plz, Johnstown, PA 15904-2833 | 2018-11-08 |
| 1255824686 | Jordan Louise Koontz | Physician Assistant | 214 College Park Plz, Johnstown, PA 15904-2833 | 2018-06-11 |
| 1770094336 | Kelley S Limerick-hand | Counselor | 214 College Park Plz, Johnstown, PA 15904-2833 | 2017-10-23 |
| 1174032064 | Natalie M Ramos | Licensed Practical Nurse | 214 College Park Plz, Johnstown, PA 15904-2833 | 2017-09-24 |
| 1386153526 | Tara Lucas | Registered Nurse | 214 College Park Plz, Johnstown, PA 15904-2833 | 2017-09-20 |
| 1710406079 | Sarah Loveridge | Social Worker | 214 College Park Plz, Johnstown, PA 15904-2833 | 2017-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407368699 | Shari Mcclaren | Counselor | 1360 Eisenhower Blvd, Ste 404, Johnstown, PA 15904 | 2017-10-29 |
| 1881126928 | Pain Medicine of York, LLC | Anesthesiology | 136 Jaycee Dr Ste 10, Johnstown, PA 15904 | 2017-03-29 |
| 1841660750 | Danielle Nicole Malzi | Occupational Therapist | 222 Luray Avenue, Johnstown, PA 15904 | 2015-10-05 |
| 1710393715 | Dlp Conemaugh Physician Practices LLC | Internal Medicine | 622 Dermuth St., Johnstown, PA 15904 | 2014-07-10 |
| 1043582406 | Bonifacio Tan Aguilera | Family Medicine | 307 Terlyn Drive, Johnstown, PA 15904 | 2012-02-01 |
| 1508159021 | Patricia S Sauka | Social Worker | 865 Eisenhower Boulevard, Johnstown, PA 15904 | 2011-05-17 |
| 1962703520 | Nathaniel Brett Beatty | Audiologist-Hearing Aid Fitter | 141 Town Center Drive, Johnstown, PA 15904 | 2010-11-12 |
| 1831324607 | Medcare Equipment Company, LLC | Durable Medical Equipment & Medical Supplies | 150 Atlantic Street, Johnstown, PA 15904 | 2009-05-22 |
| 1467667766 | Mary Alice K Burtnett | Occupational Therapist | 345 Vo Tech Drive, Johnstown, PA 15904 | 2007-05-11 |
| 1871717280 | Beverly Janik | Counselor | 214 College Park Plaza, Johnstown, PA 15904 | 2007-04-13 |
| Find all providers in zip 15904 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356335608 | Raymond Hornyak | Psychologist | 1818 Minno Dr, Johnstown, PA 15905-1731 | 2005-09-01 |
| 1598201808 | Tanya Lynn Kindel | Psychologist | 1086 Franklin St, Ground Floor Gsmc Bldg, Johnstown, PA 15905-4305 | 2017-01-10 |
| 1326296377 | Ryan Patrick Dunne | Psychologist | 320 Main St, 2nd Floor, Johnstown, PA 15901-1601 | 2008-09-03 |
| 1649435843 | Croyle-serbin Therapeutic Associates, P.C. | Psychologist | 1450 Scalp Ave, Suite 209, Johnstown, PA 15904-3374 | 2008-07-28 |
| 1659548725 | Randall Jay Harris | Psychologist | 1765 Goucher St, Johnstown, PA 15905-1101 | 2008-05-08 |
| 1497896906 | Larry J Nulton | Psychologist | 214 College Park Plz, Johnstown, PA 15904-2833 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427178 | Sabrina Hakim | Psychologist | 6001 University Boulevard, Jefferson Center 110, Moon Township, PA 15108-1189 | 2020-11-05 |
| 1447851092 | Erica Marla Schulte | Psychologist | 3535 Market St Ste 3032, Philadelphia, PA 19104-3313 | 2020-11-02 |
| 1376159780 | Kristi Corcoran | Psychologist | 212 Catharine St Apt 5, Philadelphia, PA 19147-3398 | 2020-09-21 |
| 1215541164 | Intellishyft, LLC | Psychologist | 1442 Pottstown Pike # 346, West Chester, PA 19380-1271 | 2020-09-08 |
| 1033723317 | Casey Joan Zampella | Psychologist | 2716 South St Ofc 5322, Philadelphia, PA 19146-2305 | 2020-09-03 |
| 1992314470 | Ashley Gill | Psychologist | 627 Pittsburgh Rd Ste 2, Uniontown, PA 15401-2200 | 2020-07-30 |
| 1427666726 | Chu Chian Chong | Psychologist | 510 Brighton Rd, Collegeville, PA 19426-1756 | 2020-07-22 |
| 1245848027 | Revolutionary Perspectives, LLC | Psychologist | 3-1 Bloomfield Ave, Drexel Hill, PA 19026-5555 | 2020-07-17 |
| 1609494749 | Zachary Seth Stern | Psychologist | 225 N Broad St, Allentown, PA 18104-5347 | 2020-07-06 |
| 1275150021 | Peter Bachman | Psychologist | 3501 Forbes Ave Ste 450, Pittsburgh, PA 15213-3327 | 2020-06-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.