The Kendall Anesthesia Group, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C02663 Issued in AR

Legal business name

THE KENDALL ANESTHESIA GROUP, LLC

Practice address

3490 E Fredricksburg Cir
Fayetteville, AR 72703-4821

Phone

(479) 856-1420

Fax

(479) 856-1420

NPI assigned

Jul 26, 2017

Organization subpart

No

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

Authorized official

Name

Stephanie Michelle Kendall, CRNANPI 1215902788

Title

Manager

Phone

(479) 856-1420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Michele Kendall, CRNA

  • Certified Registered Nurse Anesthetist
  • Springdale, AR
  • NPI 1215902788

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Leslie Henry, CRNA

  • Certified Registered Nurse Anesthetist
  • Springdale, AR
  • NPI 1932494218

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922522523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 E FREDRICKSBURG CIR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034821",
            "telephone_number": "479-856-1420",
            "fax_number": "479-856-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 E FREDRICKSBURG CIR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034821",
            "telephone_number": "479-856-1420",
            "fax_number": "479-856-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KENDALL ANESTHESIA GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-856-1420",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C02663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.