DR. KENDALL DENISE JEFFERSON M.D.
NPI 1861717464
Pediatrics in Kennesaw, GA

Q: What is Kendall Jefferson's NPI number?

The NPI number for Kendall Jefferson is 1861717464. It was assigned to this individual provider in the NPPES registry on April 7, 2010. The provider is also known as Ms. Kendall Denise Agochukwu MD.

Q: What is Kendall Jefferson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kendall Jefferson was last updated on March 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 07, 2010PECOS Enrolled

750 TOWNPARK LN NW, KENNESAW, GA 30144(404) 365-0966 Get Directions Write a Review

NPPES record last updated: March 8, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 8, 2022, Sep 22, 2020 (2 updates tracked since 2020).

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About Dr. Kendall Denise Jefferson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENDALL DENISE JEFFERSON M.D. (NPI 1861717464) is an individual pediatrics provider in Kennesaw, Georgia, licensed in Georgia (77694) and active in the NPI registry since April 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861717464

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. KENDALL DENISE JEFFERSONCredential: M.D.

Location Address750 TOWNPARK LN NWKennesaw, GA 30144-5824

Mailing Address750 Townpark Ln Nw Ste 113Kennesaw, GA 30144-5824 · (404) 365-0966

Phone(404) 365-0966

Sole ProprietorNo

Enumeration DateApril 7, 2010

Last NPPES UpdateMarch 8, 20222 updates tracked since enumeration

NPPES CertifiedMarch 8, 2022

✔ NPI 1861717464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in GA · 77694✔ Licensed in NC · 2013-01164

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

750 TOWNPARK LN NW, Kennesaw, GA 30144

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Other Names 1

Former Name (1)Ms. Kendall Denise Agochukwu Md

Other Identifiers 1

Other77694GA · License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kendall Denise Jefferson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kendall Jefferson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Southeast Permanente Medical Group

17 mi

Internal Medicine

3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305

Reassigned Medicare billing, Georgia enrollment
1,389 clinicians in this Medicare group

NPI 1245266956 (404) 364-3821

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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