Active NPI
Philip Kenney, MD
- Diagnostic Radiology Physician
- Little Rock, AR
National Provider Identifier
1043247547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- E-5653
- Practice address
- 4301 W Markham St # 556
Little Rock, AR 72205-7101 - Phone
- (501) 686-8000
- NPI assigned
- Jun 28, 2006
- Last updated
- Oct 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12521 | AL | |
| Diagnostic Radiology Physician | 2085R0202X | E-5653 | AR | Primary |
Addresses
Primary practice location
4301 W Markham St # 556
Little Rock, AR 72205-7101
Mailing address
4301 W Markham St # 556
Little Rock, AR 72205-7101
Phone (501) 686-8000
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009909405 | Medicaid | AL | |
| C76169 | Other | AL | VIVA |
| 000015482 | Other | AL | BLUE CROSS |
| 00117079 | Other | MS | MISSISSIPPI MEDICAID |
| 300059301 | Other | AL | RAILROAD MEDICARE |
| 051511500 | Other | AL | BLUE CROSS |
| 169640001 | Medicaid | AR | |
| 000015482 | Medicaid | AL | |
| 051505919 | Medicaid | AL | |
| 051534428 | Other | AL | BLUE CROSS |
| 009937203 | Medicaid | AL | |
| 051512215 | Other | AL | BLUE CROSS |
| 010033CC76169 | Other | AL | SECTION 1011 |
| 051505919 | Other | AL | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12521 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Alabama Health Services Foundation, PC. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223856000000",
"number": "1043247547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 556",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-686-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 556",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-686-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "PHILIP",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AL",
"license": "12521",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AR",
"license": "E-5653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009909405",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "C76169",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000015482",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI MEDICAID",
"identifier": "00117079",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300059301",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051511500",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169640001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000015482",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051505919",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051534428",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009937203",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051512215",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECTION 1011",
"identifier": "010033CC76169",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051505919",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.