Individual provider Active NPI

Gregory Allen Kendrick, M.D.

  • Internal Medicine Physician
  • Conway, AR
National Provider Identifier
1023059193
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E2187 Issued in AR
Practice address
2302 College Ave Ste 100
Conway, AR 72034-6297
Phone
(501) 513-5385
Fax
(501) 513-5257
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E2187 AR Primary

Addresses

Primary practice location

2302 College Ave Ste 100
Conway, AR 72034-6297

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other identifiers 1

IdentifierTypeStateIssuer
137703001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000497 AR Practitioner - Internal Medicine 8729040845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Regional Medical Center IncGroup PAC ID 3173428414, shared by 26 NPIs, 129 clinicians

Practice addresses (Care Compare)

2302 College Ave
Suite 100
Conway, AR 72034-6297
Phone (501) 513-5385

437 Denison St
Suite 2
Conway, AR 72034-6127
Phone (501) 504-2330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E2187ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center, Inc CurrentSince Apr 1, 2025 Accepting new patients
Conway Regional Medical Center Inc Internal Medicine CurrentSince Jan 2, 2008 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Oct 22, 2014 Accepting new patients
Conway Regional Medical Center, Inc. CurrentSince Jan 2, 2008 Accepting new patients
Conway Regional Medical Center Inc Current Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

1700 Altus St
Ste 110
Conway, AR 72032
Phone (501) 852-1366

437 Denison St
Conway, AR 72034
Phone (501) 327-1325

525 Western Ave
Ste 302
Conway, AR 72034
Phone (501) 328-5515

437 Denison St
Ste 2
Conway, AR 72034
Phone (501) 504-2330

2302 College Ave
Ste 100
Conway, AR 72034
Phone (501) 513-5385

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1023059193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE STE 100",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5385",
            "fax_number": "501-513-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "GREGORY",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E2187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137703001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.