Healthcare Provider Details

I. General information

NPI: 1548176209
Provider Name (Legal Business Name): KENADIE SHERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19722 ONE NORMAN BLVD STE 220
CORNELIUS NC
28031-5911
US

IV. Provider business mailing address

11104 BRYTON PKWY APT 5212
HUNTERSVILLE NC
28078-3792
US

V. Phone/Fax

Practice location:
  • Phone: 980-306-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: