Organization Active NPI

Thomas L Kennedy Jr MD PLLC

  • Surgery Physician
  • El Dorado, AR
National Provider Identifier
1528937844
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
THOMAS L KENNEDY JR MD PLLC
Practice address
403 W Oak St Ste 204
El Dorado, AR 71730-4574
Phone
(870) 881-9311
Fax
(870) 881-8588
NPI assigned
Nov 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Thomas Kennedy, MDNPI 1396273173
Title
Owner
Phone
(870) 881-9311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

403 W Oak St Ste 204
El Dorado, AR 71730-4574

Mailing address

403 W Oak St Ste 204
El Dorado, AR 71730-4574
Phone (870) 881-9311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260116000687 AR Part B Supplier - Clinic/Group Practice 2062999402 Receives reassigned benefits from 1 practitioner
Practice locations: El Dorado, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1528937844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W OAK ST STE 204",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304574",
            "telephone_number": "870-881-9311",
            "fax_number": "870-881-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W OAK ST STE 204",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304574",
            "telephone_number": "870-881-9311",
            "fax_number": "870-881-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS L KENNEDY JR MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-04",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-881-9311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.