Individual provider Active NPI

Denise Smith Kennedy, MD

  • Family Medicine Physician
  • Augusta, GA
National Provider Identifier
1104867191
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43984 Issued in GA
Practice address
254 Furys Ferry Rd
Augusta, GA 30907-3118
Phone
(706) 986-0999
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43984 GA Primary

Addresses

Primary practice location

254 Furys Ferry Rd
Augusta, GA 30907-3118

Mailing address

PO Box 2510
Evans, GA 30809-2510
Phone (706) 922-8251

Other practice location 1

3614 J Dewey Gray Cir Ste D
Augusta, GA 30909-6512
Phone (706) 868-7380

Other identifiers 5

IdentifierTypeStateIssuer
CH0654OtherGARR MEDICARE GROUP PIN
00793955AMedicaidGA
10056139OtherGAAMERIGROUP
336987OtherGAWELLCARE
G43984MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address denise.kennedy.1@26418.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091027000667 SC Practitioner - Family Practice 9335125350 Reassigns benefits to 1 organization
I20100311000047 GA Practitioner - Family Practice 9335125350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Primary Care PC 57 clinicians
Georgialina Physical Therapy Associates LLC 406 clinicians

Practice addresses (Care Compare)

1043 Washington Rd
Thomson, GA 30824-7318
Phone (706) 595-1461

105 E Hugh St
North Augusta, SC 29841-2925
Phone 7066507799284

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

1701 Magnolia Way
Suite 102
Augusta, GA 30909-9484
Phone (706) 922-6699

254 Furys Ferry Rd
Augusta, GA 30907-3118
Phone (706) 986-0999

3614 J Dewey Gray Cir
Suite D
Augusta, GA 30909-6512
Phone (706) 868-7380

363 N Belair Rd
Evans, GA 30809-3096
Phone (706) 650-7563

Hospital & facility affiliations

  • Trinity Home Health Home health agency, Martinez, GA, CCN 117025
  • Enhabit Home Health Home health agency, Hartwell, GA, CCN 117069
  • Centerwell Home Health Home health agency, Statesboro, GA, CCN 117033
  • Doctors Hospital Hospital, Augusta, GA, CCN 110177
  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028
  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43984GAMDFamily Medicine Physician
18787SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Primary Care PC Family Medicine CurrentSince Jul 1, 1998 Accepting new patients
Au Medical Associates Inc Past Accepting new patients

Locations

3614 J Dewey Gray Cir
Ste D
Augusta, GA 30909
Phone (706) 868-7380

254 Furys Ferry Rd
Augusta, GA 30907
Phone (706) 986-0999

363 N Belair Rd
Evans, GA 30809
Phone (706) 650-7563

105 E Hugh St
North Augusta, SC 29841
Phone (706) 650-7799

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1104867191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2510",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308092510",
            "telephone_number": "706-922-8251",
            "fax_number": "706-650-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 FURYS FERRY RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073118",
            "telephone_number": "706-986-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3614 J Dewey Gray Cir Ste D",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096512",
            "country_code": "US",
            "telephone_number": "706-868-7380",
            "fax_number": "706-868-7223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DENISE",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "43984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP PIN",
            "identifier": "CH0654",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00793955A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10056139",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "336987",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G43984",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denise.kennedy.1@26418.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "254 Furys Ferry Rd",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309073118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.