Healthcare Provider Details

I. General information

NPI: 1215867288
Provider Name (Legal Business Name): KENDRA MCCARTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13010 MORRIS ROAD BUILDING 1 SUITE 600
ALPHARETTA GA
30004-5096
US

IV. Provider business mailing address

13010 MORRIS ROAD BUILDING 1 SUITE 600
ALPHARETTA GA
30004-5096
US

V. Phone/Fax

Practice location:
  • Phone: 470-567-7378
  • Fax: 470-805-0997
Mailing address:
  • Phone: 470-567-7378
  • Fax: 470-805-0997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberPHCP044706
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberPHCP044706
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberPHCP044706
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPHCP044706
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: