Active NPI
Joseph C Kradel II, MD
- Family Medicine Physician
- Fayetteville, AR
National Provider Identifier
1619080736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E-1183
- Practice address
- 2907 E Joyce Blvd
Fayetteville, AR 72703-5011 - Phone
- (479) 442-9900
- Fax
- (479) 442-9903
- NPI assigned
- Aug 15, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E-1183 | AR | Primary |
Addresses
Primary practice location
2907 E Joyce Blvd
Fayetteville, AR 72703-5011
Mailing address
6101 Phoenix Ave Ste 3
Fort Smith, AR 72903-4826
Phone (479) 434-3431
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130872001 | Medicaid | AR | |
| 5K345 | Other | AR | BX INDIVIDUAL PROVIDER # |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-1183 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Regional Medical Center | Past | Accepting new patients |
Interoperability endpoints
- joseph.kradel.1@32512.direct.athenahealth.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1619080736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 PHOENIX AVE STE 3",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729034826",
"telephone_number": "479-434-3431",
"fax_number": "479-442-9903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 E JOYCE BLVD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727035011",
"telephone_number": "479-442-9900",
"fax_number": "479-442-9903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRADEL",
"first_name": "JOSEPH",
"middle_name": "C",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-1183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130872001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BX INDIVIDUAL PROVIDER #",
"identifier": "5K345",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.