Individual provider Active NPI

Kendra Brumley, MS PT

  • Physical Therapist
  • Camden, AR
National Provider Identifier
1740327808
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2333 Issued in AR
Practice address
638 California Ave SW
Camden, AR 71701-4604
Phone
(870) 836-1346
Fax
(870) 836-1446
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2333 AR Primary

Addresses

Primary practice location

638 California Ave SW
Camden, AR 71701-4604

Mailing address

200 Union 433
Smackover, AR 71762
Phone (870) 725-0025

Other identifiers 3

IdentifierTypeStateIssuer
157397721MedicaidAR
5Y115OtherARBLUE CROSS BLUE SHIELD
P00178743OtherARMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050221000020 AR Practitioner - Physical Therapist in Private Practice 6204884877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision One Therapy and Associates 10 clinicians

Practice addresses (Care Compare)

3286 W Hillsboro St
El Dorado, AR 71730-6734
Phone (870) 725-2497

Merit-based Incentive Payment System (MIPS)

Final score
94.34 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
81.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT2333ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision One Therapy & Associates Physical Therapist CurrentSince Dec 16, 2009 Accepting new patients
Andrew Paul Abraham PT PA Physical Therapist PastSince Sep 1, 2005 Accepting new patients
South Arkansas Orthopaedics and Sports Medicine Center PLLC Past Accepting new patients
Physical Therapy Center of South Arkansas Inc Physical Therapist PastSince Feb 1, 2004 Accepting new patients

Locations

726 California Ave SW
Camden, AR 71701
Phone (870) 836-1301

638 California Ave SW
East Camden, AR 71701
Phone (870) 836-1000

3286 W Hillsboro St
El Dorado, AR 71730
Phone (870) 725-2497

1373 Highway 79 167 Byp
Fordyce, AR 71742
Phone (870) 220-0021

4450 Smackover Hwy
Smackover, AR 71762
Phone (870) 725-2497

Organizations & group practices 4

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1740327808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNION 433",
            "city": "SMACKOVER",
            "state": "AR",
            "postal_code": "71762",
            "telephone_number": "870-725-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 CALIFORNIA AVE SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014604",
            "telephone_number": "870-836-1346",
            "fax_number": "870-836-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMLEY",
        "first_name": "KENDRA",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157397721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5Y115",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00178743",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.