Individual provider Active NPI

Kathryn Denise Hendrickson, MD

  • Pediatrics Physician
  • Fort Smith, AR
National Provider Identifier
1093774754
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N7631 Issued in AR
Practice address
7303 Rogers Ave
Fort Smith, AR 72903-4112
Phone
(479) 478-7200
Fax
(478) 478-7225
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N7631 AR Primary

Addresses

Primary practice location

7303 Rogers Ave
Fort Smith, AR 72903-4112

Mailing address

PO Box 11017
Fort Smith, AR 72917-1017
Phone (479) 478-7200

Other identifiers 3

IdentifierTypeStateIssuer
17654000000OtherQUALCHOICE
53126OtherARBLUE CROSS & BLUE SHIELD
1625759OtherCIGNA

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
I20120103000691 AR Practitioner - Pediatric Medicine 0042209512 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7631ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Partners PA Pediatrics CurrentSince Jul 8, 2004 Accepting new patients
Mercy Clinic Fort Smith Communities PastSince Oct 3, 2011 Accepting new patients

Locations

7303 Rogers Ave
Ste 201
Fort Smith, AR 72903
Phone (479) 478-7200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093774754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11017",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171017",
            "telephone_number": "479-478-7200",
            "fax_number": "478-478-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7303 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034112",
            "telephone_number": "479-478-7200",
            "fax_number": "478-478-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "KATHRYN",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "N7631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "17654000000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "53126",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1625759",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.