Katherine A Kennedy (NPI# 1902864747, PAC ID# 8325050354) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1902864747 |
| PAC ID by PECOS | 8325050354 |
| Professional Enrollment ID | I20060612000247 |
| Full Name | Katherine A Kennedy |
| Organization Legal Name | EASTSIDE GENERAL SURGERY LLC |
| Address |
98 Tara Commons Dr Loganville GA 30052-8031 |
| Phone Number | 7709727999 |
| Gender | F |
| Credential | PA |
| Graduation Year | 1988 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4880799162 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110192 | EASTSIDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 98 Tara Commons Dr, Loganville, GA 30052-8031 | 7709727999 | EASTSIDE GENERAL SURGERY LLC |
| 1800 Tree Ln, Suite 300, Snellville, GA 30078-6794 | 7709726464 | EASTSIDE GENERAL SURGERY LLC |
| Organization Legal Name | EASTSIDE GENERAL SURGERY LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew Kramer | General Surgery | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Vonda R Ware | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Janice H Pressley | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Brittany M Merritt | Obstetrics/gynecology | Eastside General Surgery LLC | 1800 Tree Ln, Suite 300, Snellville, GA 30078-6794 |
| Hisa Yamaguchi | General Surgery | Eastside General Surgery LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Peter C Mann | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Betsy G Weiss | Physician Assistant | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Carmen C Mcgee | Obstetrics/gynecology | Eastside General Surgery LLC | 1800 Tree Ln, Suite 300, Snellville, GA 30078-6794 |
| Street Address |
98 TARA COMMONS DR |
| City | LOGANVILLE |
| State | GA |
| Zip | 30052-8031 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew Kramer | General Surgery | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Vonda R Ware | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Janice H Pressley | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Peter C Mann | Obstetrics/gynecology | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Betsy G Weiss | Physician Assistant | Eastside General Surgery LLC | 98 Tara Commons Dr, Loganville, GA 30052-8031 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Z Mikrut | Internal Medicine | 902 Athens Hwy, Loganville, GA 30052 | |
| Germaine D Cummings | Family Medicine | 4480 Atlanta Hwy, Loganville, GA 30052 | |
| Harrison C Ojimma | Certified Registered Nurse Anesthetist (crna) | 367 Athens Hwy 100, Loganville, GA 30052-2207 | |
| Angelina Postoev | General Surgery | Georgia Surgicare | 367 Athens Hwy, Bldg 100 Suite 100, Loganville, GA 30052-2207 |
| Christopher Alade Ibikunle | General Surgery | Georgia Surgicare | 367 Athens Hwy, Bldg 100 Suite 100, Loganville, GA 30052-2207 |
| Angel F Farinas | General Surgery | Georgia Surgicare | 367 Athens Hwy, Bldg 100 Suite 100, Loganville, GA 30052-2207 |
| Christian X Cruz Pico | General Surgery | Georgia Surgicare | 367 Athens Hwy, Loganville, GA 30052-2207 |
| Jean Cadet | Nurse Practitioner | Neuro Behavioral Health Associates, LLC | 367 Athens Hwy 1050, Loganville, GA 30052-2270 |
| Kenyatta Merriweather | Nurse Practitioner | Neuro Behavioral Health Associates, LLC | 367 Athens Hwy 1050, Loganville, GA 30052-2270 |
| Mandy Michelle Miller | Clinical Social Worker | 125 Lee Byrd Rd, Loganville, GA 30052-2310 | |
| Find all physicians in zip 30052 | |||
| City | LOGANVILLE |
| Zip Code | 30052 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LOGANVILLE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Katherine A Kennedy.
| 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.