Kennesaw Mountain Medical Group
NPI 1235378324 · Primary Care Clinic/Center · Kennesaw, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kennesaw Mountain Medical Group is a Primary Care Clinic/Center organization in Kennesaw, GA (NPI 1235378324).
Provider details
- NPI number
- 1235378324
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Gregory Matechak, Physician(770) 422-5880
- License
- 52992 (GA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2009-02-12
- Last updated
- 2009-02-12
Frequently asked questions
- What is Kennesaw Mountain Medical Group's NPI number?
- Kennesaw Mountain Medical Group's National Provider Identifier (NPI) is 1235378324, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kennesaw Mountain Medical Group?
- Kennesaw Mountain Medical Group is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kennesaw Mountain Medical Group located?
- Kennesaw Mountain Medical Group's practice location on file with NPPES is 1600 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4301.
- What is Kennesaw Mountain Medical Group's phone number?
- The practice phone number listed in the NPPES registry for Kennesaw Mountain Medical Group is (770) 422-5880.
- Does Kennesaw Mountain Medical Group accept Medicare?
- Kennesaw Mountain Medical Group is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kennesaw Mountain Medical Group?
- The authorized official listed on Kennesaw Mountain Medical Group's NPPES record is Gregory Matechak, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kennesaw Mountain Medical Group's NPI active?
- Yes — Kennesaw Mountain Medical Group's NPI (1235378324) is active in the NPPES registry as of the last update on 2009-02-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.