Provider Demographics
NPI:1649069501
Name:KENNY, JOSHUA TIMOTHY (CPO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TIMOTHY
Last Name:KENNY
Suffix:
Gender:
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 1ST NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4544
Mailing Address - Country:US
Mailing Address - Phone:423-307-1890
Mailing Address - Fax:423-307-1891
Practice Address - Street 1:622 W 1ST NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4544
Practice Address - Country:US
Practice Address - Phone:423-307-1890
Practice Address - Fax:423-307-1891
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT00000000304222Z00000X
TNPRO00000000296224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist