KATHERINE KENNEDY – Physician Assistant, NPI 1619651965

KATHERINE KENNEDY is a healthcare provider. based in Macon, Georgia. specializing in PHYSICIAN ASSISTANT. The NPI Number for KATHERINE KENNEDY is 1619651965

Main info

Female
7 Years Of Experience
Name
KATHERINE KENNEDY
NPI
1619651965
Phone
(478) 747-7403
Address
5 DUNEDIN CT
Enumeration Date
14 June 2023
Last Update Date
14 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4246008360
Graduation Year
2019 (7 years ago)
PAC ID
6901241223
Group Practice PAC ID
9931555141
Professional Enrollment ID
I20260304003214
Address ID
CA941173608SA350XXAVEX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

4,430 PHYSICIAN ASSISTANT in GA

Provider Addresses for KATHERINE KENNEDY

  • 5 DUNEDIN CT

    MACON, GA 312105393

    Phone: (478) 747-7403

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $51.

Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Alkermes, Inc. ($19).

Total Amount

$51

General + Research + Ownership

Payments

3

Total payment records

General Amount

$51

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227001020IPhysician AssistantCOTBD
I20260304003214IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31210)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931555141View full group profile
NameSpecialtyState
Nurse PractitionerMD
Physician AssistantCA
Physician AssistantCA
Physician AssistantAZ
Internal MedicineCA
Nurse PractitionerCO
Physician AssistantCA
Nurse PractitionerFL
Nurse PractitionerCA
Physician AssistantPA

Reviews

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Frequently asked questions

Does KATHERINE KENNEDY have a public NPI I can cite?
Public records show KATHERINE KENNEDY under NPI 1619651965.
Is KATHERINE KENNEDY currently accepting referrals based on NPI status?
Registry metadata lists KATHERINE KENNEDY as active.
How should patients interpret KATHERINE KENNEDY's specialty?
The extract shows Physician Assistant for KATHERINE KENNEDY. Clinical services aligned with this taxonomy classification.
Can patients visit KATHERINE KENNEDY in Macon, Georgia?
For routing, start with Macon, Georgia for KATHERINE KENNEDY, then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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