Individual provider Active NPI

Ronalda Kennedy, NP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1457855108
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN188241 Issued in GA
Practice address
865 N Highland Ave NE
Atlanta, GA 30306-4565
Phone
(866) 389-2727
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN188241 GA Primary

Addresses

Primary practice location

865 N Highland Ave NE
Atlanta, GA 30306-4565

Mailing address

865 N Highland Ave NE
Atlanta, GA 30306-4565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190311001292 GA Practitioner - Nurse Practitioner 3072852987 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

1700 Hospital S Dr
Austell, GA 30106-8159

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN188241GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergent Testing LLC CurrentSince Sep 1, 2021 Accepting new patients
The Southeast Permanente Medical Group CurrentSince Dec 12, 2022 Accepting new patients
Medcura Health, Inc. CurrentSince Jan 28, 2019 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Medcura Health, Inc. CurrentSince Jan 28, 2019 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Oct 12, 2020 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

3540 Cobb Pkwy NW
Acworth, GA 30101
Phone (770) 974-3911

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1220 Caroline St NE
Ste A230
Atlanta, GA 30307
Phone (678) 710-3980

1700 Hospital South Dr
Ste 504
Austell, GA 30106
Phone (770) 819-8211

13 Corporate Blvd NE
Ste 250
Brookhaven, GA 30329
Phone (229) 442-7210

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

Organizations & group practices 8

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1457855108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "RONALDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN188241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.