Active NPI
Robert Thomas Kendrick, M.D
- Family Medicine Physician
- Jena, LA
National Provider Identifier
1265568869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 013234
- Practice address
- 180 Ninth Street
Suite J
Jena, LA 71342-2780 - Phone
- (318) 992-4275
- Fax
- (318) 992-6312
- NPI assigned
- Feb 26, 2007
- Last updated
- Sep 14, 2010
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 013234 | LA | |
| Family Medicine Physician | 207Q00000X | 013234 | LA | Primary |
Addresses
Primary practice location
180 Ninth Street
Suite J
Jena, LA 71342-2780
Mailing address
PO Box 2780
Jena, LA 71342-2780
Phone (318) 992-4275
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13234 | Other | LA | STATE LICENSE |
| 1191825 | Medicaid | LA |
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 |
|---|---|---|---|
| 013234 | LA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1265568869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2780",
"city": "JENA",
"state": "LA",
"postal_code": "713422780",
"telephone_number": "318-992-4275",
"fax_number": "318-992-6312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 NINTH STREET",
"address_2": "SUITE J",
"city": "JENA",
"state": "LA",
"postal_code": "713422780",
"telephone_number": "318-992-4275",
"fax_number": "318-992-6312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "ROBERT",
"middle_name": "THOMAS",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "LA",
"license": "013234",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "013234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "13234",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1191825",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jena, LA
- Stephen Thomas Jones, PHARMD
- Just Health
- Just Health
- Kassie Tannehill Therapy Services, LLC
- Kathleen Kendrick, PHARM D
- Lasalle Association for the Developmentally Delayed, Inc
- Lasalle Association for the Developmentally Delayed, Inc
- Lasalle Association for the Developmentally Delayed, Inc.
- Lasalle Family Medicine
- Lasalle Kidcare
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.