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Bryasha Kennebrew

Physician β€’ Columbus, GA

Active NPI 1912752452 Individual Practitioner Female Practitioner
Practice location in NPPES

1350 15th Ave Ste 103
Columbus, GA 319012308

Call 7627205029 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1350 15th Ave Ste 103

Columbus, GA 319012308

Telephone 7627205029
Organization at the Same NPPES Address or Phone
Blue Skies Healthcare Llc Facility NPI 1972330538

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-07
Home Health Primary Specialty

NUCC Taxonomy Code: 251E00000X

License # reported to NPPES GA 23252679

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location April 07, 2025

Registered at 1350 15TH AVE STE 103, COLUMBUS, GA 319012308 (Tel: 7627205029)

πŸ“
Updated Business Mailing Address April 07, 2025

Registered at 1350 15TH AVE STE 135015TH, COLUMBUS, GA 319012308 (Tel: 7627205029)

βœ…
NPI Profile Active April 18, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 18, 2024

Registered at 2312 FRANCIS ST, COLUMBUS, GA 319062513 (Tel: 7067505742)

πŸ“
Business Mailing Address (Initial Record) April 18, 2024

Registered at 3649 SURREY LN, COLUMBUS, GA 319062747 (Tel: 7067505742)

πŸ‘€
Provider Name / Credentials (Initial Record) April 18, 2024

Recorded as BRYASHA KENNEBREW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2024

Home Health (license number reported to NPPES: GA 23252679)

🟒
Initial NPI Registration & Enumeration April 18, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1912752452
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2024
Last Update: April 07, 2025
Sole Proprietor: Yes

Mailing Address

1350 15th Ave Ste 135015th

Columbus, GA 319012308

Phone: 7627205029

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.