Maria M Kennickell (NPI# 1447400171, PAC ID# 8820155922) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1447400171 |
| PAC ID by PECOS | 8820155922 |
| Professional Enrollment ID | I20170804003103 |
| Full Name | Maria M Kennickell |
| Organization Legal Name | CHARLESTON GASTROENTEROLOGY SPECIALISTS |
| Address |
1962 Charlie Hall Blvd Charleston SC 29414-5837 |
| Phone Number | 8437228000 |
| Gender | F |
| Medical School | GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3173437472 |
| Number of Group Practice Members | 31 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420065 | BON SECOURS-ST FRANCIS XAVIER HOSPITAL |
| 420087 | ROPER HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 | 8437228000 | CHARLESTON GASTROENTEROLOGY SPECIALISTS |
| Organization Legal Name | CHARLESTON GASTROENTEROLOGY SPECIALISTS |
| Physicians | 32 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Lauren Kowal | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Thomas D Carico | Pathology | Charleston Gastroenterology Specialists | 328 Midland Pkwy, Summerville, SC 29485-8102 |
| Tara A Queener | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Frank Overdyk | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Summar C Phillips | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Mark W West | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Robert S Smith | Internal Medicine | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Shaughnessy V Mullen | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Eddie L Irions Jr. | Gastroenterology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Norman H Brahen | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Street Address |
1962 CHARLIE HALL BLVD |
| City | CHARLESTON |
| State | SC |
| Zip | 29414-5837 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Lauren Kowal | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Tara A Queener | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Frank Overdyk | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Summar C Phillips | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Mark W West | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Robert S Smith | Internal Medicine | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Shaughnessy V Mullen | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Eddie L Irions Jr. | Gastroenterology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Norman H Brahen | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Geoffrey Nicholas Kredich | Anesthesiology | Charleston Gastroenterology Specialists | 1962 Charlie Hall Blvd, Charleston, SC 29414-5837 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacy H Lawton | Nurse Practitioner | Minuteclinic Diagnostic South Carolina LLC | 2566 Ashley River Rd, Charleston, SC 29414-4605 |
| Sherrill G Bradsher | Nurse Practitioner | Minuteclinic Diagnostic South Carolina LLC | 2566 Ashley River Rd, Charleston, SC 29414-4605 |
| Anthony C Azzolino | Chiropractic | 2352 Ashley River Rd, Charleston, SC 29414-4752 | |
| Marcus R Hostetler | Chiropractic | 2411 Savannah Hwy, Suite 3, Charleston, SC 29414-5320 | |
| William S Ottinger | Obstetrics/gynecology | Charleston Ob/gyn LLC | 1027 Physicians Dr, Suite 110, Charleston, SC 29414-5351 |
| Margaret Crosby Papadea | Obstetrics/gynecology | Charleston Ob/gyn LLC | 1027 Physicians Dr, Suite 110, Charleston, SC 29414-5351 |
| Jennifer Fouquette Fisher | Obstetrics/gynecology | Charleston Ob/gyn LLC | 1027 Physicians Dr, Suite 110, Charleston, SC 29414-5351 |
| Denise Hays Devine | Obstetrics/gynecology | Charleston Ob/gyn LLC | 1027 Physicians Dr, Suite 110, Charleston, SC 29414-5351 |
| Roy D Mckinney | Optometry | 3050 Ashley Town Ctr Dr, Charleston, SC 29414-5664 | |
| Sasha Milleman Perez | Family Medicine | Palmetto Primary Care Physicians | 3030 Ashley Town Ctr Dr, Suite 102a, Charleston, SC 29414-5678 |
| Find all physicians in zip 29414 | |||
| City | CHARLESTON |
| Zip Code | 29414 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CHARLESTON + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Maria M Kennickell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.