Kevin D Ganong, M.D.
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Jonesboro, AR
NPI 1699730762 · NPPES record last updated Jan 14, 2016
Key facts
- NPI
- 1699730762
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- E-1711 (AR)
- Practice address
- 4802 E Johnson Ave
Jonesboro, AR 72401-8413 - Phone
- (870) 936-8000
- Fax
- (870) 934-3639
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- Jefferson Medical College of Thomas Jefferson University, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Arkansas Clinic Charitable Foundation, Inc.
Practice addresses (Care Compare)
1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432
1500 McLain St
Newport, AR 72112-3638
Phone (870) 523-9337
2205 W Parker Rd
Jonesboro, AR 72404-7778
Phone (870) 933-9250
3001 Apache Dr
Suite B
Jonesboro, AR 72401-7447
Phone (870) 936-8000
4700 W Kingshighway
Paragould, AR 72450-3465
Phone (870) 240-8402
4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
4808 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
527 N 6TH St
Blytheville, AR 72315-2407
Phone (870) 936-8000
616 W Keiser Ave
Osceola, AR 72370-3504
Phone (870) 563-5888
Hospital & facility affiliations
- Baptist Memorial Hospital Jonesboro, Inc.
- Piggott Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.65 of 100
- Quality
- 44.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100513000598 | AR | Practitioner - Endocrinology | 9133264799 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| Northeast Arkansas Clinic, PA | Past | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Past | Accepting new patients |
Locations
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
311 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-4150
4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820
1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432
Interoperability endpoints
- kganong29467@direct.bmhcc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | E-1711 | AR | Yes |
Addresses
Primary practice location
4802 E Johnson Ave
Jonesboro, AR 72401-8413
Mailing address
PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000
Other providers in Jonesboro, AR
- Iesha Gammon-Coleman
- Emily Gammon
- Paige Gander
- Darrell R Gann
- Jeresa Gann
- Andrew Gantt
- Stephanie Ganus
- Lawrence Zachary Gardanier
- Amy Gardner
- Jason Gardner
All providers in Jonesboro, AR · Endocrinology, Diabetes & Metabolism Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.