KELLI KENNEDY (PT, DPT) – Physical Therapist, NPI 1164201059

KELLI KENNEDY (PT, DPT) is a healthcare provider. based in Sarasota, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 2305216701 (VA). The NPI Number for KELLI KENNEDY (PT, DPT) is 1164201059

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLI KENNEDY (PT, DPT)
NPI
1164201059
Phone
Not provided
Address
350 BRADEN AVE
Enumeration Date
28 September 2023
Last Update Date
15 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9414848107
Graduation Year
2023 (3 years ago)
PAC ID
6709326085
Group Practice PAC ID
3476684069
Professional Enrollment ID
I20241114002048
Address ID
FL342857123VE834XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for KELLI KENNEDY (PT, DPT)

  • 350 BRADEN AVE

    SARASOTA, FL 342432001

    Phone:

    Type: Mailing

  • 834 PINEBROOK RD

    VENICE, FL 342857123

    Phone: (941) 484-8107

    Fax: (941) 484-5186

    Type: Location

  • 10504 Wakeman Dr

    Fredericksburg, VA 224078040

    Phone: (540) 315-8249

    Type: Location

  • 350 Braden Ave

    Sarasota, FL 342432001

    Phone: (941) 355-7637

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240913000151IPhysical Therapist In Private PracticeVATBD
I20241114002048IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34243)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476684069View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeDE

Reviews

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Frequently asked questions

Can I cross-check KELLI KENNEDY (PT, DPT) using NPI 1164201059?
NPI 1164201059 belongs to KELLI KENNEDY (PT, DPT); compare other details if you need extra assurance.
Would KELLI KENNEDY (PT, DPT) appear as active to a payer?
You can treat KELLI KENNEDY (PT, DPT) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is KELLI KENNEDY (PT, DPT)?
KELLI KENNEDY (PT, DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for KELLI KENNEDY (PT, DPT)?
Travel planning: use Sarasota, Florida as the reference point for KELLI KENNEDY (PT, DPT), then confirm.
Does KELLI KENNEDY (PT, DPT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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