Individual provider Active NPI

Kenneth Herbert Drewery III, EP-C, CET

  • Clinical Exercise Physiologist
  • Atlanta, GA
National Provider Identifier
1588506174
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
License
2001337 Issued in GA
Practice address
125 Decatur St SE
Atlanta, GA 30303-3201
Phone
(404) 413-8050
NPI assigned
Apr 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiology Technician 246W00000X Z5Q5N4X3 GA
Clinical Exercise Physiologist 224Y00000X 2001337 GA Primary

Addresses

Primary practice location

125 Decatur St SE
Atlanta, GA 30303-3201

Mailing address

1880 E Harrison St
Chandler, AZ 85225-9075

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

LicenseStateTypeSpecialty
2001337GAMDClinical Exercise Physiologist
Z5Q5N4X3GAMDCardiology Technician

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1588506174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 E HARRISON ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852259075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DECATUR ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033201",
            "telephone_number": "404-413-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREWERY",
        "first_name": "KENNETH",
        "middle_name": "HERBERT",
        "name_suffix": "III",
        "credential": "EP-C, CET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246W00000X",
            "taxonomy_group": "",
            "desc": "Technician, Cardiology",
            "state": "GA",
            "license": "Z5Q5N4X3",
            "primary": false
        },
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "GA",
            "license": "2001337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.