Individual provider Active NPI

Sarah Michelle Kennedy, PHARMD

  • Pharmacist
  • Newnan, GA
National Provider Identifier
1164718557
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40691 Issued in FL
Practice address
555 Bullsboro Dr
Newnan, GA 30265-1045
Phone
(770) 502-9360
Fax
(770) 502-9360
NPI assigned
Jun 23, 2011
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40691 FL Primary
Pharmacist 183500000X RPH025769 GA

Addresses

Primary practice location

555 Bullsboro Dr
Newnan, GA 30265-1045

Mailing address

555 Bullsboro Dr
Newnan, GA 30265-1045
Phone (770) 502-9360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS40691FLMDPharmacist
RPH025769GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1164718557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BULLSBORO DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651045",
            "telephone_number": "770-502-9360",
            "fax_number": "770-502-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BULLSBORO DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651045",
            "telephone_number": "770-502-9360",
            "fax_number": "770-502-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SARAH",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40691",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH025769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.