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

Keith Bradley Pennycook, DO

Individual provider Dermatology Physician · NPI 1821651944

Keith Bradley Pennycook, DO is a Dermatology in Cumming, Georgia. Graduated from Michigan State University College of Osteopathic Medicine in 2019, 7 years ago. Practices with Aqua Dermatology of Georgia PC, a 56-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
GA
In the registry since
2019
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2870 Ronald Reagan Blvd Ste 103
Cumming, GA 30041-6092
Phone: (248) 601-4900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 86267 (GA)

Record details

NPI number1821651944
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 15, 2019
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025
Mailing address2870 Ronald Reagan Blvd Ste 103, Cumming, GA 30041-6092

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2019 (7 years in practice)
Group practice Aqua Dermatology Of Georgia Pc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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