MEDICARE: KERRI CASSIDY MCKINNEY PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1457436255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI CASSIDY MCKINNEY PAC

Provider Business Mailing Address
First Line	:	PO BOX 80883
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30608-0883
Country	:	US
Telephone Number	:	706-549-8114
Fax Number	:	706-549-7558

Provider Business Practice Location Address
First Line	:	601 BROAD ST SE STE B
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3718
Country	:	US
Telephone Number	:	678-989-1515
Fax Number	:	770-868-5650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	03/17/2018

Similar Medicare Providers

1730043217 — SOUTHERN NEUROSURGERY LLC
Practice Location Address:

601 BROAD ST SE STE A
GAINESVILLE, GA
30501-3718

Practice Phone: 770-503-4446
Practice Fax:

1780971994 — DR. ANKUR BHARAT PATEL D.O.
Practice Location Address:

601 BROAD ST SE STE B
GAINESVILLE, GA
30501-3718

Practice Phone: 678-971-4167
Practice Fax: 833-989-2501

1417337320 — MARGARET ANN RISO M.D.
Practice Location Address:

601 BROAD ST SE STE B
GAINESVILLE, GA
30501-3718

Practice Phone: 678-971-4167
Practice Fax:

1265037600 — NORTHEAST GEORGIA SURGERY CENTER
Practice Location Address:

601 BROAD ST SE STE E
GAINESVILLE, GA
30501-3718

Practice Phone: 678-971-4227
Practice Fax: 678-971-4238

1336744770 — SOUTHERN PAIN AND SPINE ASSOCIATES LLC
Practice Location Address:

601 BROAD ST SE STE B
GAINESVILLE, GA
30501-3718

Practice Phone: 678-971-4167
Practice Fax: 833-989-2501

1508648445 — SOUTHERN INJURY SPECIALISTS LLC
Practice Location Address:

601 BROAD ST SE STE A
GAINESVILLE, GA
30501-3718

Practice Phone: 678-971-4167
Practice Fax: 833-989-2501

Directions to “ KERRI CASSIDY MCKINNEY PAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.