Ian James Kendrick, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

10155A Issued in WY

Practice address

190 Arrowhead Dr
Evanston, WY 82930-9266

Phone

(307) 783-8255

Fax

(307) 783-8167

NPI assigned

Jun 2, 2010

Last updated

Sep 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Family Practice

Education

University of Utah School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evanston Clinic CorpGroup PAC ID 8325038094, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evanston Regional Hospital Hospital, Evanston, WY, CCN 531319

Merit-based Incentive Payment System (MIPS)

Final score

74.28 of 100Reported as group

Quality

48.55

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

81.25 of 100Reported as group

Quality

67.93

Promoting interoperability

100

Improvement activities

40

Cost

69.58

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ian.kendrick.1@1583.direct.athenahealth.com
• Direct secure messaging: ikendric@yourcarecommunity.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evanston Clinic Corp

  • Family Medicine Physician
  • Evanston, WY
  • NPI 1013916519

  Surgery

  Medicare reassignment Care Compare group NPD

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

• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • General Acute Care Hospital
  • Evanston, WY
  • NPI 1639140015
  Care Compare affiliation

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1902126824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 ARROWHEAD DR 6",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829308752",
            "telephone_number": "307-783-8398",
            "fax_number": "307-783-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ARROWHEAD DR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309266",
            "telephone_number": "307-783-8255",
            "fax_number": "307-783-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "IAN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "TL2981",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "10155A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Kallbacka
• Tadge M Kanjo, M.D.
• Rachael Kankamp, PHARMD
• Sharon Kay, PHD
• Victoria Kelm-Foy
• Janile Susan Kennedy, LICENSED NURSE
• Cora Klotzbach, PSYD
• Douglas Cottreu Knighton
• Karrie L Knopf, PA-C
• Mark J Kroll-Fratoni

• Surgery Physician in Evanston, WY
• Providers in Evanston, WY by specialty
• Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.