MRS. FELICIA D KENNICOTT (NPI# 1376710541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376710541 |
| Entity Type | Individual |
| Full Name | MRS. FELICIA D KENNICOTT |
| Credential | PA-C |
| Practice Address |
100 Goshen Rd Rincon GA 31326-5545 |
| Mailing Address |
Po Box 818 Springfield GA 31329-0818 |
| Practice Telephone | 9128266000 |
| Practice Fax Number | 9128266016 |
| Mailing Telephone | 9127546451 |
| Mailing Fax Number | 9127549901 |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2018-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5317 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 GOSHEN RD |
| City | RINCON |
| State | GA |
| Zip Code | 31326-5545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845458 | Christopher Joseph Mathews | Specialist | 100 Goshen Rd, Rincon, GA 31326-5545 | 2005-07-20 |
| 1528379070 | Stephanie T. Reese | Family Medicine | 100 Goshen Rd, Rincon, GA 31326-5744 | 2010-06-30 |
| 1700105004 | Xiaofeng Zhong | Family Medicine | 100 Goshen Rd, Rincon, GA 31326-5744 | 2010-05-26 |
| 1184800435 | Hospital Authority of Effingham County | Health Maintenance Organization | 100 Goshen Rd, Rincon, GA 31326-5545 | 2008-01-17 |
| 1922218296 | David L Williford | Pharmacist | 100 Goshen Rd, Rincon, GA 31326-5545 | 2007-05-23 |
| 1811020407 | Effingham Hospital, Inc. | Clinic/Center | 100 Goshen Rd, Rincon, GA 31326-5545 | 2007-03-13 |
| 1669447694 | Maria E Rivera | Family Medicine | 100 Goshen Rd, Rincon, GA 31326 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657160 | Vitality Counseling, Inc | Counselor | 135 Goshen Road Ext Ste 203, Rincon, GA 31326 | 2018-01-29 |
| 1174045322 | Katelyn Dodsworth Sundin | Dentist | 5871 Ga-21 S, Rincon, GA 31326 | 2017-07-10 |
| 1861943284 | Covenant Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 112 Goshen Commercial Park Dr., Rincon, GA 31326 | 2016-10-20 |
| 1013465681 | Aaron D. Webb | Nurse Practitioner | 423 S Columbia Avenue, Rincon, GA 31326 | 2016-09-13 |
| 1659726255 | Reagan Reese Powell | Counselor | 135 Goshen Rd Ext, Suite 203a, Rincon, GA 31326 | 2016-05-02 |
| 1982065652 | Shronda Bowman | Specialist | 1214n Columbia Ave, Unit B, Rincon, GA 31326 | 2016-03-09 |
| 1306202890 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 461 S Columbia Ave, Rincon, GA 31326 | 2016-01-13 |
| 1053628255 | Jennifer Erin Creech | Dentist | 429 S Columbia Ave, Rincon, GA 31326 | 2010-09-09 |
| 1548596737 | Rincon Medical Center | Clinic/Center | 119 Chimney Road, Rincon, GA 31326 | 2009-10-23 |
| 1770732968 | Hospital Authority of Effingham County | Clinic/Center | 110 Goshen Road, Rincon, GA 31326 | 2008-09-12 |
| Find all providers in zip 31326 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962853911 | Marcy King | Physician Assistant | 131 Goshen Road Ext Ste 300, Rincon, GA 31326-5590 | 2016-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.