Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Johannah Rose Kennedy, PA-C

Individual provider Physician Assistant · NPI 1235935123

Johannah Rose Kennedy, PA-C is a Physician Assistant in Southfield, Michigan. Qualified in 2024, 2 years ago. Practices with Ear Nose and Throat Consultants PC, a 29-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

29201 Telegraph Rd Ste 500
Southfield, MI 48034-7648
Phone: (248) 569-5985
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 31450 7 Mile Rd, Livonia, MI 48152-1374 — (248) 569-5985
  • 27483 Dequindre Rd Ste 201, Madison Heights, MI 48071-5711 — (248) 569-5985
  • 26850 Providence Pkwy Ste 165, Novi, MI 48374-1255 — (248) 569-5985
  • 26110 Harper Ave, Saint Clair Shores, MI 48081-3774 — (248) 569-5985

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601013016 (MI)

Record details

NPI number1235935123
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 21, 2025
Last updated in NPPESFebruary 21, 2025
Certification dateFebruary 20, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ear Nose And Throat Consultants Pc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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