Ahtyanna Kendrick, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN308162 Issued in GA

Practice address

626 Dallas Hwy
Villa Rica, GA 30180-1209

Phone

(770) 459-9378

NPI assigned

Jul 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Westcare Villa Rica Pediatrics

  • Pediatrics Physician
  • Villa Rica, GA
  • NPI 1487742532
  NPD (past)

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1437830775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 PRINCETON LAKES PKWY SW APT 1002",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315533",
            "telephone_number": "229-854-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 DALLAS HWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801209",
            "telephone_number": "770-459-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "AHTYANNA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN308162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Journeys Counseling Center, LLC
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• Katelyn Karbowski, PT, DPT, ATC/L
• Tatum Kegley
• Deborah Keller, M.ED.,CCC-SLP
• Jessica Catherine Kennedy, LPC
• Keyline Home Care Solutions, LLC
• Keziah Hair Extensions
• Nizamuddin Khaja, M.D.
• John Kamau Kiarie

• All providers in Villa Rica, GA
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.