Sheryl Ann Kennedy, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Peach Tree City, GA
NPI 1821151978 · NPPES record last updated Jan 5, 2017
Key facts
- NPI
- 1821151978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN070145 (GA)
- Practice address
- 8 Eastbrook Bend
Suite B
Peach Tree City, GA 30269 - Phone
- (770) 487-2273
- Fax
- (770) 487-2228
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040108000584 | GA | Practitioner - Nurse Practitioner | 3971402892 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Emory Clinic Inc | Current |
Accepting new patients | |
| Emory Specialty Associates, LLC | Current |
Accepting new patients | |
| Southeast Medical Group, P.C. | Current |
Accepting new patients | |
| Peachtree City Urgent Care, Inc | Current |
Accepting new patients | |
| Gwinnett Clinic LTD | Past | Accepting new patients | |
| Physician First Health Network | Past |
Accepting new patients |
Locations
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812
1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091
1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350
4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406
141 Lacy St NW
Ste 100
Marietta, GA 30060
Phone (770) 615-1350
8 Eastbrook Bnd
#B
Peachtree Cty, GA 30269
Phone (770) 487-2273
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DIJIBA
- skennedy27890@direct.emory.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN070145 | GA | Yes |
Addresses
Primary practice location
8 Eastbrook Bend
Suite B
Peach Tree City, GA 30269
Mailing address
8 Eastbrook Bend
Suite B
Peach Tree City, GA 30269
Phone (770) 487-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 942218511C | Medicaid | GA |
Other names
- Sheryl Ann Kennedy
Other providers in Peach Tree City, GA
All providers in Peach Tree City, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2017. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.