Individual provider Active NPI

John Henry Kendrick, MD

  • Surgery Physician
  • Springdale, AR
National Provider Identifier
1902812019
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C5210 Issued in AR
Practice address
4704 Trout Farm Rd
Springdale, AR 72762-8830
Phone
(479) 738-1700
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C5210 AR Primary
General Practice Physician 208D00000X C5210 AR

Addresses

Primary practice location

4704 Trout Farm Rd
Springdale, AR 72762-8830

Mailing address

PO Box 6220
Springdale, AR 72766-6220

Other identifiers 8

IdentifierTypeStateIssuer
105085001MedicaidAR
3904680OtherARHEALTHSOURCE - CIGNA
52839OtherARBLUE CROSS/BLUE SHIELD
12311000000OtherARQUALCHOICE
182856OtherARHEALTHLINK
450521250OtherARUNITED HEALTHCARE
770045401MedicaidAR
450521250727640000OtherARCHAMPUS/TRICARE

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
I20031218000988 AR Practitioner - General SurgeryPractitioner - General Practice 4082511738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: General Practice
Education
University of Arkansas College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minimal Access Surgery IncGroup PAC ID 1951295575, 2 clinicians

Practice addresses (Care Compare)

5230 Willow Creek Dr
Suite 201
Springdale, AR 72762-0899
Phone (479) 927-3100

Merit-based Incentive Payment System (MIPS)

Final score
97.63 of 100Reported as individual
Quality
94.48
Improvement activities
40
Cost
85.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5210ARMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minimal Access Surgery Inc Surgery CurrentSince Aug 6, 2003 Accepting new patients

Locations

705 Phillips Pl
Huntsville, AR 72740
Phone (479) 738-1700

5230 Willow Creek Dr
Ste 201
Springdale, AR 72762
Phone (479) 287-4370

601 W Maple Ave
Ste 411
Springdale, AR 72764
Phone (479) 757-5354

5230 Willow Creek Dr
Springdale, AR 72762
Phone (479) 322-5145

Interoperability endpoints

  • Direct secure messaging: jkendrick23146@washingtonregional.direct-ci.com
  • Direct secure messaging: jkendrick@minimalaccess.mdlogic.direct-ci.com

Organizations & group practices 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1902812019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6220",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727666220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 TROUT FARM RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628830",
            "telephone_number": "479-738-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "C5210",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "C5210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105085001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE - CIGNA",
            "identifier": "3904680",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "52839",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "12311000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "182856",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "450521250",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "770045401",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "450521250727640000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.