DR. PHILIP R KENNEDY (NPI# 1912903485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912903485 |
| Entity Type | Individual |
| Full Name | DR. PHILIP R KENNEDY |
| Credential | MD |
| Practice Address |
3400 Mcclure Bridge Rd Suite D401 Duluth GA 30096-6675 |
| Practice Telephone | 7706222230 |
| Practice Fax Number | 7706229741 |
| Mailing Telephone | 7706222230 |
| Mailing Fax Number | 7706229741 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2009-01-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
GA03970B | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000772813A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720506363 | Philip Neil Kennedy II | Pharmacist | 106 21st Street, Nitro, WV 25143 | 2017-09-05 |
| 1427250968 | Philip Douglas Kennedy | Chiropractor | 43931 Division St, Lancaster, CA 93535 | 2007-06-05 |
| 1477549418 | Philip A Kennedy | Family Medicine | 698 Deep Woods Dr, Aurora, OH 44202-9761 | 2005-09-26 |
| 1982129748 | Philip Michael Kennedy | Physical Therapist | 3301 New Mexico Ave Nw Ste 248, Washington, DC 20016-3610 | 2017-08-13 |
| Street Address |
3400 MCCLURE BRIDGE RD SUITE D401 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-6675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063860740 | Alpha Recovery Group Inc | Health Maintenance Organization | 3400 Mcclure Bridge Rd, Building C, Suit A&b, Duluth, GA 30096-6675 | 2016-06-02 |
| 1679960884 | Allys Sernior Services, Inc. | Health Maintenance Organization | 3400 Mcclure Bridge Rd, Building C-301, Duluth, GA 30096-6675 | 2015-04-26 |
| 1972889491 | Hand To Shoulder Therapy Specialists of Duluth | Occupational Therapist | 3400 Mcclure Bridge Rd, F601, Duluth, GA 30096-6675 | 2011-10-28 |
| 1154586667 | Mbs Connection LLC | Clinic/Center | 3400 Mcclure Bridge Rd, Bldg F, Ste A, Duluth, GA 30096-6675 | 2008-07-24 |
| 1164614608 | Community Neurological Clinic | Specialist | 3400 Mcclure Bridge Rd, Suite D401, Duluth, GA 30096-6675 | 2007-08-17 |
| 1285793372 | Glen C Mcintosh | Dentist | 3400 Mcclure Bridge Rd, Building G, Suite B, Duluth, GA 30096-6675 | 2006-12-06 |
| 1871688317 | James Clinton Cronan Jr. | Plastic Surgery | 3400 Mcclure Bridge Rd, Building B201, Duluth, GA 30096-6675 | 2006-10-03 |
| 1902818032 | Michelle Morante | Physician Assistant | 3400 Mcclure Bridge Rd, Building B, Duluth, GA 30096-6675 | 2006-08-13 |
| 1578574455 | Choice Chiropractic and Wellness, Inc. | Chiropractor | 3400 Mcclure Bridge Rd, Building B, Suite C, Duluth, GA 30096-6675 | 2006-08-10 |
| 1417977885 | Surgical Assistants of America, Inc. | Physician Assistant | 3400 Mcclure Bridge Rd, Building B201, Duluth, GA 30096-6675 | 2006-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497905913 | Dong Wang | Psychiatry & Neurology | 3790 Pleasant Hill Rd Ste 250, Duluth, GA 30096-5150 | 2008-09-20 |
| 1174718027 | Roberta Ruth Hallquist | Psychiatry & Neurology | 2812 E Superior St, Duluth, MN 55812-2345 | 2007-09-12 |
| 1760528418 | Amber Irene Erickson | Psychiatry & Neurology | 400 E. 3rd St, Smdc Medical Center - Duluth Clinic, Duluth, MN 55805 | 2007-01-29 |
| 1588669253 | Douglas W Kaplan | Psychiatry & Neurology | 1012 E 2nd St, Duluth, MN 55805-2200 | 2005-06-17 |
| 1518346188 | Jacob Andrew Hvidston | Psychiatry & Neurology | 400 E 3rd St, Duluth, MN 55805-1951 | 2015-05-28 |
| 1679961551 | St. Luke's Hospital of Duluth | Psychiatry & Neurology | 1012 E 2nd St, Duluth, MN 55805-2200 | 2014-12-31 |
| 1922417633 | Georgia Neurodiagnostic & Treatment Center LLC. | Psychiatry & Neurology | 3790 Pleasant Hill Rd Ste 250, Duluth, GA 30096-5150 | 2014-08-06 |
| 1013203033 | Chena Margaret-filizetti Beauduy | Psychiatry & Neurology | 400 E 3rd St, Essentia Health Duluth Clinic, Duluth, MN 55805-1951 | 2011-06-28 |
| 1548572647 | Aboubakar Sharaf | Psychiatry & Neurology | 400 E 3rd St, Essentia Health Duluth Clinic, Duluth, MN 55805-1951 | 2010-07-06 |
| 1912132572 | Brian Patrick Moran | Psychiatry & Neurology | 400 E 3rd St, Duluth, MN 55805-1951 | 2009-05-26 |
| Find all providers in DULUTH | ||||
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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.