Individual provider Active NPI

Janine Marie Kennedy, PA-C

  • Physician Assistant
  • Ooltewah, TN
National Provider Identifier
1780971945
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5741 Issued in TN
Practice address
9058 Old Lee Hwy
Ooltewah, TN 37363-5631
Phone
(423) 531-9110
Fax
(423) 476-5887
NPI assigned
Jul 7, 2011
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5741 TN Primary

Addresses

Primary practice location

9058 Old Lee Hwy
Ooltewah, TN 37363-5631

Mailing address

9058 Old Lee Hwy
Ooltewah, TN 37363-5631
Phone (423) 531-9110

Other names 1

  • Janine Marie Boyt Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140603000563 CO Practitioner - Physician Assistant 0244453652
I20231010002673 TN Practitioner - Physician Assistant 0244453652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DX Mso PLLCGroup PAC ID 7719131101, 88 clinicians

Practice addresses (Care Compare)

1521 Gunbarrel Rd
Suite 103
Chattanooga, TN 37421-3124
Phone (423) 458-1426

170 Mouse Creek Rd NW
Cleveland, TN 37312-3840
Phone (423) 458-1426

713 Winfield Dunn Pkwy
Suite 9
Sevierville, TN 37876-5533
Phone (423) 458-1426

9058 Old Lee Hwy
Ooltewah, TN 37363-5631
Phone (423) 458-1426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Urgent Care and Family Care of WNC, PLLC PastSince Apr 6, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1780971945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9058 OLD LEE HWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373635631",
            "telephone_number": "423-531-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9058 OLD LEE HWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373635631",
            "telephone_number": "423-531-9110",
            "fax_number": "423-476-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JANINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANINE",
            "last_name": "BOYT",
            "middle_name": "MARIE",
            "credential": "MMS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.