Individual provider Active NPI

Mackenzie Kennedy

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1386533933
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017776 Issued in GA
Practice address
11490 Alpharetta Hwy Ste 200
Roswell, GA 30076-3866
Phone
(770) 752-9478
NPI assigned
Jun 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017776 GA Primary

Addresses

Primary practice location

11490 Alpharetta Hwy Ste 200
Roswell, GA 30076-3866

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250821000171 GA Practitioner - Physical Therapist in Private Practice 7810497237 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

11490 Alpharetta Hwy
Suite 200
Roswell, GA 30076-3866
Phone (770) 740-8592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017776GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jun 30, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12850 Highway 9 N
Ste 1050
Alpharetta, GA 30004
Phone (678) 332-5800

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1370 Buford Hwy
Ste 108
Cumming, GA 30041
Phone (770) 205-1669

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1386533933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 ALPHARETTA HWY STE 200",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763866",
            "telephone_number": "770-752-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.