STEPHANIE A KENNEALLY MOT, OTR/L
NPI 1104101617
Contractor in Freehold, NJ

Active since October 15, 2011Accepts Medicare Assignment
40 CANTERBURY DR, FREEHOLD, NJ 07728(732) 266-8814 Get Directions Write a Review

NPPES record last updated: April 9, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stephanie A Kenneally Mot, Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHANIE A KENNEALLY MOT, OTR/L (NPI 1104101617) is an individual contractor provider in Freehold, New Jersey, licensed in New Jersey (46TR0542000) and active in the NPI registry since October 2011. She maintains a secondary practice location in East Brunswick and is a graduate of Other (2011).

NPPES Registry Identity

NPI1104101617
Entity TypeIndividualFemale
Primary Taxonomy171W00000X
Provider Legal NameSTEPHANIE A KENNEALLYCredential: MOT, OTR/L
Location Address40 CANTERBURY DRFreehold, NJ 07728-4421
Mailing Address257b Matchaponix AveMonroe, NJ 08831-4034 · (732) 266-8814
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateOctober 15, 2011
Last NPPES UpdateApril 9, 2019
NPI 1104101617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyContractorOther Service Providers
Taxonomy Code171W00000X
License Licensed in NJ · 46TR0542000
Definition
For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no relation to a provider's employment status.
40 CANTERBURY DR, Freehold, NJ 07728

Other Names 1

Former Name (1)Stephanie A Blanar

Secondary Practice Location 1

Location 138 Hillwood RdEast Brunswick, NJ 08816-4622 · Phone (732) 266-8814

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Stephanie A Kenneally Mot, Otr/l is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163697871
PECOS Enrollment IDI20111208000135

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Occupational Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Physical Therapist (Orthopedic)
40 CANTERBURY DR
FREEHOLD, NJ 07728
Occupational Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Physical Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Occupational Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Physical Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728
Physical Therapist
40 CANTERBURY DR
FREEHOLD, NJ 07728

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephanie Kenneally's NPI number?

The NPI number for Stephanie Kenneally is 1104101617. It was assigned to this individual provider in the NPPES registry on October 15, 2011. The provider is also known as Stephanie A Blanar.

Where is Stephanie Kenneally located?

Stephanie Kenneally practices at 40 Canterbury Dr, Freehold, NJ 07728. The listed phone number is (732) 266-8814.

What is Stephanie Kenneally's specialty?

The primary specialty registered for this NPI is Contractor with taxonomy code 171W00000X.

Is Stephanie Kenneally enrolled in Medicare?

Yes. Stephanie Kenneally is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Stephanie Kenneally was last updated on April 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.