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

Mr. Charles Reggie Kennedy Sr., CERTIFIEDORTHOTIST

Individual provider Orthotist · NPI 1548583172

Mr. Charles Reggie Kennedy Sr., CERTIFIEDORTHOTIST is an Orthotist in Jackson, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2010

Practice location Address checks out

777 Lakeland Dr
Jackson, MS 39216-4611
Phone: (601) 815-4844
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthotist (primary) Taxonomy 222Z00000X · Licence C0004097 (MS)

Record details

NPI number1548583172
Entity typeIndividual (Type 1)
GenderMale
Credentials CERTIFIEDORTHOTIST
Sole proprietorYes
NPI enumeratedMarch 10, 2010
Last updated in NPPESMarch 10, 2010

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