Individual provider Active NPI

Lee W. Kendrick, M.D.

  • Specialist
  • Sherwood, AR
National Provider Identifier
1780655167
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C7713 Issued in AR
Practice address
2215 Wildwood Ave
Suite 204
Sherwood, AR 72120-5089
Phone
(501) 753-2424
Fax
(501) 753-2733
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C7713 AR Primary

Addresses

Primary practice location

2215 Wildwood Ave
Suite 204
Sherwood, AR 72120-5089

Mailing address

2215 Wildwood Ave
Suite 204
Sherwood, AR 72120-5089
Phone (501) 753-2424

Other identifiers 1

IdentifierTypeStateIssuer
128293001MedicaidAR

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
I20080815000607 AR Practitioner - Pulmonary Disease 7315012911 Practice locations: North Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Arkansas College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3401 Springhill Dr
Suite 240
North Little Rock, AR 72117-2926
Phone (501) 753-2424

Hospital & facility affiliations

  • Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036
  • Baptist Health Medical Center Heber Springs Hospital, Heber Springs, AR, CCN 041312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C7713ARMDSpecialist

Hospital & facility affiliations 2

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1780655167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 WILDWOOD AVE",
            "address_2": "SUITE 204",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205089",
            "telephone_number": "501-753-2424",
            "fax_number": "501-753-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 WILDWOOD AVE",
            "address_2": "SUITE 204",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205089",
            "telephone_number": "501-753-2424",
            "fax_number": "501-753-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "LEE",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "C7713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128293001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.