Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kennedy Williams

Individual provider Physical Therapist · NPI 1689393787

Kennedy Williams is a Physical Therapist in Private Practice in Boise, Idaho. Qualified in 2022, 4 years ago. Practices with Scolispine PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Georgia and Idaho.

Years since qualifying
4
Licensed in
GA, ID
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

7219 W Potomac Dr
Boise, ID 83704-9182
Phone: (208) 908-8540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-8919 (ID)
Physical Therapist Taxonomy 225100000X · Licence PT016185 (GA)

Record details

NPI number1689393787
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 23, 2022
Last updated in NPPESOctober 11, 2023
Certification dateOctober 11, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Scolispine Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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