John Daniel Kennedy, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

022573 Issued in GA

Practice address

1650 County Services Pkwy SW
Marietta, GA 30008-4010

Phone

(770) 514-2300

NPI assigned

Jun 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Surgical Assistants of America, Inc.

  • Surgery Physician
  • Duluth, GA
  • NPI 1417977885
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1568664258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "022573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jed James Kendall, MD
• Jack Neil Kendrick, CRNA
• Julia Patricia Kendrick
• Anna Kennedy, LPC
• Erin Simone Kennedy
• Melissa Love Kennedy, DMD
• Kennesaw Mountain Clinc Inc
• Kennestone Dental Care Center PC
• Kennestone Dental Designs, LLC
• Kennestone Dentist LLC

• Surgery Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.