Active NPI
Kunta Kennedy
- Driver
- Albany, GA
National Provider Identifier
1295513232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 047597856
- Practice address
- 2024 W Oglethorpe Ave Apt 15
Albany, GA 31707-4162 - Phone
- (229) 291-8311
- NPI assigned
- Sep 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 047597856 | GA | |
| Driver | 172A00000X | 047597856 | GA | Primary |
Addresses
Primary practice location
2024 W Oglethorpe Ave Apt 15
Albany, GA 31707-4162
Mailing address
2024 W Oglethorpe Ave Apt 15
Albany, GA 31707-4162
Phone (229) 291-8311
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047597856 | GA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1295513232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2024 W OGLETHORPE AVE APT 15",
"city": "ALBANY",
"state": "GA",
"postal_code": "317074162",
"telephone_number": "229-291-8311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2024 W OGLETHORPE AVE APT 15",
"city": "ALBANY",
"state": "GA",
"postal_code": "317074162",
"telephone_number": "229-291-8311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "KUNTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "GA",
"license": "047597856",
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "GA",
"license": "047597856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.