Kcp Enterprises is a medicare enrolled "Physical Medicine & Rehabilitation" provider in Morrow, Georgia. Their current practice location is
1568 Southlake Pkwy Ste C, Morrow, Georgia. You can reach out to their office (for appointments etc.) via phone at
(470) 878-0696.
Kcp Enterprises is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Kcp Enterprises
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1043679418.
Healthcare Provider's Profile
| Full Name | Kcp Enterprises |
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| Type | Facility |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 1568 Southlake Pkwy Ste C, Morrow, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043679418
- Provider Enumeration Date: 02/15/2016
- Last Update Date: 12/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 7517303613
- Enrollment ID: O20240312001492
Medical Identifiers
Medical identifiers for Kcp Enterprises such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1043679418 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Kcp Enterprises acts as a billing entity for following providers:
| Provider Name | Sendhil Subramanian |
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| Provider Type | Practitioner - Interventional Radiology |
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| Provider Identifiers | NPI Number: 1902883168
PECOS PAC ID: 4981516689
Enrollment ID: I20040728000877 |
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| Provider Name | Cornell Peters |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1861487225
PECOS PAC ID: 1557492758
Enrollment ID: I20100702000437 |
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| Provider Name | Victor Osisanya |
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| Provider Type | Practitioner - Pain Management |
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| Provider Identifiers | NPI Number: 1679884753
PECOS PAC ID: 8628393451
Enrollment ID: I20150218002209 |
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| Provider Name | Sheimeita Chance |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1144692500
PECOS PAC ID: 5092012880
Enrollment ID: I20160322001125 |
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| Provider Name | Vandy Gaffney |
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| Provider Type | Practitioner - Anesthesiology |
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| Provider Identifiers | NPI Number: 1730470329
PECOS PAC ID: 3274776869
Enrollment ID: I20170509001065 |
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| Provider Name | Anslie Prudhomme |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1285126391
PECOS PAC ID: 9234574641
Enrollment ID: I20240226001094 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kcp Enterprises is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kcp Enterprises
1568 Southlake Pkwy Ste C,
Morrow, GA 30260-4153
Ph: (470) 878-0696 | Kcp Enterprises
1568 Southlake Pkwy Ste C,
Morrow, GA 30260
Ph: (470) 878-0696 |
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