Active NPI
Walter Kendrick, MHPP
- Case Manager/Care Coordinator
- Forrest City, AR
National Provider Identifier
1154860799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1825 E Broadway St
Forrest City, AR 72335-3409 - Phone
- (870) 630-2328
- Fax
- (870) 630-2348
- NPI assigned
- Feb 15, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1825 E Broadway St
Forrest City, AR 72335-3409
Mailing address
1825 E Broadway St
Forrest City, AR 72335-3409
Phone (870) 630-2328
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1154860799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 E BROADWAY ST",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "723353409",
"telephone_number": "870-630-2328",
"fax_number": "870-630-2348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 E BROADWAY ST",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "723353409",
"telephone_number": "870-630-2328",
"fax_number": "870-630-2348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "WALTER",
"credential": "MHPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-15",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forrest City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.