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

Individual provider Physician Assistant · NPI 1811088685

Karen M Pennelli, PA is a Physician Assistant in Canton, Georgia. Graduated from Northwestern University Feinberg Medical School in 1996, 30 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and Massachusetts.

Years since qualifying
30
Trained at
Northwestern University Feinberg Medical School
Licensed in
GA, MA
In the registry since
2006
Specialties on file
3
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

470 Northside Cherokee Blvd Ste 170
Canton, GA 30115-8029
Phone: (770) 721-9540
Fax: (770) 721-9541
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3400 Old Milton Pkwy # C, Alpharetta, GA 30005-3707 — (770) 667-4337

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 008027 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 784 (MA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA784 (MA)

Record details

NPI number1811088685
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 27, 2006
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolNORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduated 1996 (30 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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