Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andre Johnathan Kennedy, PA

Individual provider Physician Assistant · NPI 1962900357

Andre Johnathan Kennedy, PA is a Physician Assistant in West Columbia, South Carolina. Qualified in 2017, 9 years ago. Practices with Carolina Urology Partners PLLC, a 37-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
9
Licensed in
SC
In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

111 W Hospital Dr
West Columbia, SC 29169-3405
Phone: (803) 796-8515
Fax: (803) 796-8515
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2832 (SC)

Record details

NPI number1962900357
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 31, 2018
Last updated in NPPESMay 26, 2021
Certification dateMay 26, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Carolina Urology Partners Pllc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in West Columbia