Donald Franklin Kennedy Jr., M.D.
Individual provider Active NPI Surgery Physician · Reidsville, GA
NPI 1710947403 · NPPES record last updated Mar 8, 2016
Key facts
- NPI
- 1710947403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 024278 (GA)
- Practice address
- 131 Memorial Drive
Reidsville, GA 30453 - Phone
- (912) 557-6224
- Fax
- (912) 557-3198
- NPI assigned
- Mar 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 54.22 of 100
- Quality
- 71.46
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 59.28
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20051206000018 | GA | Practitioner - General Surgery | 0143240184 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24278 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald F Kennedy Jr MD PC | Specialist | Past |
Accepting new patients |
Interoperability endpoints
- donald.kennedy@healthiealerts.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 24278 | GA | |
| Surgery Physician | 208600000X | 024278 | GA | Yes |
Addresses
Primary practice location
131 Memorial Drive
Reidsville, GA 30453
Mailing address
460 Mall Blvd
Ste B
Savannah, GA 31406-4801
Phone (912) 644-5300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000279408B | Medicaid | GA |
Other providers in Reidsville, GA
- Warren Allen James
- Dana B Jones
- K-Lab and More
- Ihori Kameyama
- Kemps Pharmacy Inc
- Brady Jane Kicklighter
- Michael Lockley
- Mark Spivey Orthopedic Clinic LLC
- Sherry Richardson May
- April D McBroom
All providers in Reidsville, GA · Surgery Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2016. 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.