KENNEDY TINER – Hospice Registered Nurse, NPI 1639065956

KENNEDY TINER is a healthcare provider. based in Augusta, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN295362 (GA). The NPI Number for KENNEDY TINER is 1639065956

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
KENNEDY TINER
NPI
1639065956
Phone
Not provided
Address
2945 WALTON WAY
Enumeration Date
13 June 2025
Last Update Date
13 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7313941145
Graduation Year
2025 (1 year ago)
PAC ID
7113433343
Group Practice PAC ID
5395284616
Professional Enrollment ID
I20250723002273
Address ID
GA310213918DU606XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for KENNEDY TINER

  • 2945 WALTON WAY

    AUGUSTA, GA 309093827

    Phone:

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-07-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20250723002273INurse PractitionerGATBD

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 30909)

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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: 5395284616View full group profile
NameSpecialtyState
Family PracticeTN
Nurse PractitionerGA
Nurse PractitionerTN
Hospitalist, Internal MedicineGA
Internal MedicineGA
Nurse PractitionerFL
Internal MedicineGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerMD

Reviews

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Frequently asked questions

How do I look up KENNEDY TINER by NPI?
Use NPI 1639065956 when you need to reference KENNEDY TINER in forms, claims, or directories.
Is KENNEDY TINER's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does KENNEDY TINER treat or focus on?
Patients typically see KENNEDY TINER under the specialty Hospice Registered Nurse. Clinical services aligned with this taxonomy classification.
What location metadata exists for KENNEDY TINER?
The page summarizes Augusta, Georgia for KENNEDY TINER; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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