Individual provider Active NPI

Michael Gregory Kendrick, M.D.

  • Diagnostic Radiology Physician
  • Little Rock, AR
National Provider Identifier
1801069331
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E-8555 Issued in AR
Practice address
800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone
(501) 404-8007
Fax
(501) 904-3620
NPI assigned
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 036161743 IL
Diagnostic Radiology Physician 2085R0202X MD449095 PA
Diagnostic Radiology Physician 2085R0202X E-8555 AR Primary

Addresses

Primary practice location

800 Fair Park Blvd
Little Rock, AR 72204-1720

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 404-8007

Other identifiers 1

IdentifierTypeStateIssuer
202861001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, IL, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140612001613 AR Practitioner - Diagnostic Radiology 4385877265 Reassigns benefits to 2 organizations
I20220829003024 IL Practitioner - Diagnostic Radiology 4385877265 Reassigns benefits to 1 organization
I20220914001146 PA Practitioner - Diagnostic Radiology 4385877265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 500-3500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036161743ILMDDiagnostic Neuroimaging (Radiology) Physician
E-8555ARMDDiagnostic Radiology Physician
MD449095PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Imaging SC CurrentSince Jul 1, 2022 Accepting new patients
Suburban Orthopaedics LTD CurrentSince Aug 15, 2022 Accepting new patients
Orthoarkansas, PA CurrentSince Apr 1, 2025 Accepting new patients
Satish a Shah MD PC CurrentSince Jul 1, 2022 Accepting new patients
Orthoarkansas, PA CurrentSince Apr 1, 2025 Accepting new patients
St Vincent Infirmary Medical Center Past Accepting new patients
Scancare Diagnostics LLC Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

1110 W Schick Rd
Bartlett, IL 60103
Phone (630) 233-7029

20 Expedition Trl
Ste 100
Gettysburg, PA 17325
Phone (717) 334-8333

20 Expedition Trl
Ste 101
Gettysburg, PA 17325
Phone (717) 334-4033

20 Expedition Trl
Ste 103
Gettysburg, PA 17325
Phone (717) 337-5991

Organizations & group practices 7

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1801069331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "MICHAEL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "IL",
            "license": "036161743",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD449095",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-8555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202861001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.