Andre Johnathan Kennedy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2832 Issued in SC

Practice address

111 W Hospital Dr
West Columbia, SC 29169-3405

Phone

(803) 796-8515

Fax

(803) 796-8515

NPI assigned

Jan 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Urology Partners PLLCGroup PAC ID 8921280587, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: andre.kennedy.p1@direct.cup.nextgenshare.com

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.

• Carolina Urology Partners PLLC

  • Urology Physician
  • Huntersville, NC
  • NPI 1013210004

  SC

  Medicare reassignment Care Compare group
• Carolina Urology Practice

  • Specialist
  • West Columbia, SC
  • NPI 1447395066
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lexington Health Inc

  dba Lexington Medical Center

  • General Acute Care Hospital
  • West Columbia, SC
  • NPI 1386241834
  Care Compare affiliation

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1962900357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE STE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789120",
            "telephone_number": "704-414-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HOSPITAL DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693405",
            "telephone_number": "803-796-8515",
            "fax_number": "803-796-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ANDRE",
        "middle_name": "JOHNATHAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-31",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA DEPARTMENT OF LABOR, LICENSING AND REGULATION",
            "identifier": "2832",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary L Kemick, M.D.
• Brett Kemper, MD
• Kristen Kendall, RN
• Kenley Loftis D.M.D PA
• Virgil J Kenneda, DO
• Jessica Jeanette Kennedy, PT, DPT
• Kallean J Kennedy, DO
• Lauren Vinoski Kennedy, OTR/L
• Raegan Kennedy, PHARMD
• Emily McGuire Kennell, PHARMD

• Physician Assistant in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.