Individual provider Active NPI

Daniel James Kenan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1760624936
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
9700307 Issued in NC
Practice address
10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone
(501) 604-2695
Fax
(501) 604-2699
NPI assigned
Apr 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 9700307 NC Primary

Addresses

Primary practice location

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386

Mailing address

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170203000725 AR Practitioner - Pathology 3072730365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Duke University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephropathology Associates, PLCGroup PAC ID 6901707405, 30 clinicians

Practice addresses (Care Compare)

10810 Executive Ctr Dr
Suite 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9700307NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ell Pathology Lab, LLC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Nephropathology Associates, PLC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1760624936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENAN",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-02",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "9700307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.