Kevin Bradley Meredith
Individual provider Active NPI Pulmonary Disease Physician · Rogers, AR
NPI 1093009078 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1093009078
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- E-8782 (AR)
- Practice address
- 2708 S Rife Medical LN Ste 200
Rogers, AR 72758-1456 - Phone
- (479) 338-3080
- Fax
- (479) 338-3089
- NPI assigned
- Jun 7, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- University of Arkansas College of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Northwest Arkansas Communities
Practice addresses (Care Compare)
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000
Hospital & facility affiliations
- Mercy Hospital Northwest Arkansas
- Mercy Hospital Berryville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160623001391 | AR | Practitioner - Pulmonary Disease |
9436475936 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
2710 S Rife Medical Ln
Ste 200
Rogers, AR 72758
2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000
2708 S Rife Medical Ln
Ste 200
Rogers, AR 72758
Phone (479) 338-3080
Interoperability endpoints
- kmeredith750430@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | E-8782 | AR | |
| Pulmonary Disease Physician | 207RP1001X | E-8782 | AR | Yes |
Addresses
Primary practice location
2708 S Rife Medical LN Ste 200
Rogers, AR 72758-1456
Mailing address
2708 S Rife Medical LN Ste 200
Rogers, AR 72758-1456
Phone (479) 338-3080
Other providers in Rogers, AR
- Mercy Hospital Rogers
- Mercy Hospital Springfield
- Mercy Hospital Springfield
- Mercy Pharmacy Services, LLC
- Mercy Pharmacy Services, LLC
- Joshua D. Merriman
- Darah Merritt
- James Milton Merritt
- Sarah Elizabeth Merryman
- John D Mertz
All providers in Rogers, AR · Pulmonary Disease Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.