Individual provider Active NPI

Kennady Galloway Fox, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1972392637
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18864 Issued in TX
Practice address
3304 Rosedale Ave
Dallas, TX 75205-1462
Phone
(601) 260-7121
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 PA18864 TX Primary

Addresses

Primary practice location

3304 Rosedale Ave
Dallas, TX 75205-1462

Mailing address

3304 Rosedale Ave
Dallas, TX 75205-1462
Phone (601) 260-7121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20251106005462 TX Practitioner - Physician Assistant 1557851581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frisco Dermatology AssociatesGroup PAC ID 4789683665, 5 clinicians

Practice addresses (Care Compare)

3880 Parkwood Blvd
Suite 102
Frisco, TX 75034-1929
Phone (972) 704-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18864TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frisco Dermatology Associates CurrentSince Sep 17, 2025 Accepting new patients

Locations

3880 Parkwood Blvd
Ste 102
Frisco, TX 75034
Phone (972) 704-2400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1972392637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 ROSEDALE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051462",
            "telephone_number": "601-260-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 ROSEDALE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051462",
            "telephone_number": "601-260-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "KENNADY",
        "middle_name": "GALLOWAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.