Geena Rose Kennedy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001011977 Issued in NC

Practice address

3007 Wesley Chapel Stouts Rd
Monroe, NC 28110-4007

Phone

(704) 412-3612

Fax

(704) 412-3614

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• SCRN LLC

  • Urgent Care Clinic/Center
  • Monroe, NC
  • NPI 1487181897
  Medicare reassignment

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1942885017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 WESLEY CHAPEL STOUTS RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281104007",
            "telephone_number": "919-454-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 WESLEY CHAPEL STOUTS RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281104007",
            "telephone_number": "704-412-3612",
            "fax_number": "704-412-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GEENA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001011977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Clinic of Chiropractic of Monroe
• Tonya Cherese Kelly, FNP
• Robert G. Kelso
• Jessica Kempton, LCMHC-A
• Alfred Kendrick
• Kenney Orthopedics of Monroe, LLC
• Kenney Orthopedics of Monroe, LLC
• Michelle Marie Kerr, PA
• Shaun Key
• Dara Khalatbari, M.D.

• Medical Physician Assistant in Monroe, NC
• Providers in Monroe, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.