Individual provider
CRYSTAL KENNERLY
CMS NPPES lists CRYSTAL KENNERLY as an individual provider record with NPI 1063335925. The current record reports a primary practice location in ACWORTH, GA and primary taxonomy code 106H00000X.
Type 1 NPIs identify individual healthcare providers. How to read this profile
01
Practice locations
- Primary practice location3950 COBB PKWY NW STE 401ACWORTH, GA 301019528
Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.
02
Taxonomy information
106H00000XPrimary reported taxonomy
Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.
03
NPI record information
- NPI status
- Enumerated in NPPES
- Enumeration date
- July 30, 2026
An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.