Individual provider Active NPI

Kashondra Denae Harris, FNP

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1104458751
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN220216 Issued in GA
Practice address
2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone
(866) 389-2727
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AP70014578 WA
Family Medicine Physician 207Q00000X 0024188994 VA
Family Medicine Physician 207Q00000X 5022496 NC
Family Medicine Physician 207Q00000X APN0102926-C-NP CO
Family Medicine Physician 207Q00000X 0038608 OH
Family Medicine Physician 207Q00000X A185201 IA
Family Medicine Physician 207Q00000X 1176309 TX
Family Medicine Physician 207Q00000X 26NJ15421300 NJ
Family Medicine Physician 207Q00000X APRN11030058 FL
Family Medicine Physician 207Q00000X 40023 TN
Family Nurse Practitioner 363LF0000X RN220216 GA Primary

Addresses

Primary practice location

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Mailing address

120 Grafton St
Hampton, GA 30228-3824
Phone (478) 719-2286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201215001298 GA Practitioner - Nurse Practitioner 7416369541 Reassigns benefits to 3 organizations
I20251105001862 NJ Practitioner - Nurse Practitioner 7416369541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Family Medical and Urgent Care Clinic of McDonough, LLCGroup PAC ID 7113054131, 20 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

1631 Hwy 20 W
McDonough, GA 30253-7311
Phone (770) 288-2822

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0102926-C-NPCOMDFamily Medicine Physician
APRN11030058FLMDFamily Medicine Physician
A185201IAMDFamily Medicine Physician
5022496NCMDFamily Medicine Physician
26NJ15421300NJMDFamily Medicine Physician
0038608OHMDFamily Medicine Physician
40023TNMDFamily Medicine Physician
1176309TXMDFamily Medicine Physician
AP70014578WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Associates, LLC Family Medicine Current Accepting new patients
Georgia Emergency Group, LLC CurrentSince Apr 1, 2021 Accepting new patients
Minuteclinic Diagnostic of New Jersey LLC Family Medicine CurrentSince Oct 22, 2025 Accepting new patients
Minuteclinic LLC Family CurrentSince Feb 12, 2025 Accepting new patients
Family Medical and Urgent Care Clinic of McDonough, LLC Family Medicine CurrentSince Jun 7, 2021 Accepting new patients
Donna M. Haney M.D., P.C. Family Medicine PastSince Jun 7, 2021 Accepting new patients

Locations

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

2782 N Cobb Pkwy NW
Kennesaw, GA 30152
Phone (770) 420-1092

1631 Highway 20 W
McDonough, GA 30253
Phone 7702882822 ext. 135

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

230 Plaza Dr
Zebulon, GA 30295
Phone (404) 569-1310

471 Main St
Chatham, NJ 07928
Phone (973) 635-4636

4 Ryan Rd
Marlboro, NJ 07746
Phone (732) 431-8700

307 Egg Harbor Rd
Sewell, NJ 08080
Phone (856) 589-1177

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJFBD
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: kashondra.harris.d1.p1@direct.alegiscare.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1104458751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GRAFTON ST",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283824",
            "telephone_number": "478-719-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KASHONDRA",
        "middle_name": "DENAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP70014578",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024188994",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "5022496",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "APN0102926-C-NP",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "0038608",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "A185201",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1176309",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ15421300",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11030058",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "40023",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN220216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.