Elicia Kennedy, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C7147 Issued in AR

Practice address

9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202

Phone

(501) 202-4000

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323
  Medicare reassignment NPD
• Baptist Health

  • Cardiovascular Disease Physician
  • Little Rock, AR
  • NPI 1578593067
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1346359478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD",
            "address_2": "STE. 500",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113702",
            "telephone_number": "501-202-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 INTERSTATE 630 EXIT 7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057202",
            "telephone_number": "501-202-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ELICIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C7147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112798001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Reagan Kendall, APRN
• Anna Kendrick, M.D.
• Michael Gregory Kendrick, M.D.
• Chasity Jewell Kendricks, PT, DPT
• Eleanor E Kennedy, MD
• Huber Frazier Kennedy, M.D.
• Iris T Kennedy, APRN
• Joshua L. Kennedy, M.D.
• Kimberly Kennedy, LPC
• Kira Rinehart Kennedy, LCSW

• Emergency Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.