Audra Kennedy, M.D.
Individual provider Active NPI Family Medicine Physician · Graham, TX
NPI 1609329671 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1609329671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- S4508 (TX)
- Practice address
- 820 Montgomery Rd Ste 202
Graham, TX 76450-4200 - Phone
- (940) 549-7741
- Fax
- (855) 615-3435
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Nebraska College of Medicine, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
101 W Renner Rd
Suite 440
Richardson, TX 75082-2018
359 N Post Oak LN Apt
Suite 320
Houston, TX 77024-5945
820 Montgomery Rd
Suite 202
Graham, TX 76450-4200
Hospital & facility affiliations
- Beyondfaith Homecare & Rehab of Graham LLC
- Graham Regional Medical Center
- Hamilton Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260518001498 | TX | Practitioner - Family Practice | 1850679960 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S4508 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graham Hospital District | Family Medicine | Current |
Accepting new patients |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Graham Regional Medical Center | Past |
Accepting new patients |
Locations
820 Montgomery Rd
Ste 202
Graham, TX 76450
Phone (940) 549-7741
Interoperability endpoints
- https://api.platform.athenahealth.com/5873/brand/1/csg/1/fhir/r4
- akennedy@direct-address.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | S4508 | TX | Yes |
Addresses
Primary practice location
820 Montgomery Rd Ste 202
Graham, TX 76450-4200
Mailing address
820 Montgomery Rd Ste 202
Graham, TX 76450-4200
Phone (940) 549-7741
Other providers in Graham, TX
- Steven Kent Jones
- Jordan Pharmacy
- Roy B Jordan
- Christine Liz Joseph
- Victoria Clarke Keller
- Edward Stanton Key
- Sharla Kay King
- Frederick Koberg
- Thomas Earl Labbe
- Lisa Gaye Lacher
All providers in Graham, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.