Healthcare Provider Details

I. General information

NPI: 1225963879
Provider Name (Legal Business Name): KENNEDI ANN RHODES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENNEDI ANN FITZGERALD PA-C

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 INSPIRATION BLVD
MADISON TN
37115-3171
US

IV. Provider business mailing address

740 INSPIRATION BLVD
MADISON TN
37115-3171
US

V. Phone/Fax

Practice location:
  • Phone: 832-562-6541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: