Kendall D. Wagner, M.D., PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KENDALL D. WAGNER, M.D., PLLC

Practice address

500 S University Ave Ste 702
Little Rock, AR 72205-5309

Phone

(501) 766-6311

Fax

(472) 227-2345

NPI assigned

Oct 20, 2021

Last updated

Sep 13, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kendall Darren Wagner, MDNPI 1699091264

Title

Physician

Phone

(501) 766-6311

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kendall Darren Wagner, M.D.

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1699091264
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789257600000",
    "number": "1528721271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 MIRAMONT CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722233301",
            "telephone_number": "501-766-6311",
            "fax_number": "479-227-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 702",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055309",
            "telephone_number": "501-766-6311",
            "fax_number": "472-227-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL D. WAGNER, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "DARREN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "501-766-6311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202855001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Kemp, MHPP
• Susan Alynn Kemp, MD
• William F Kemp, PD
• Monica Nafarrete Kemph, M.D.
• Daniel James Kenan, M.D.
• Chloe Kendall, M.S., CCC-SLP
• Jeremy Reagan Kendall, APRN
• Anna Kendrick, M.D.
• Michael Gregory Kendrick, M.D.
• Chasity Jewell Kendricks, PT, DPT

• Primary Care Clinic/Center in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.