MR. ROGER O KENNEDY (NPI# 1659484848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659484848 |
| Entity Type | Individual |
| Full Name | MR. ROGER O KENNEDY |
| Credential | CRNA |
| Practice Address |
1100 E Poplar St Clarksville AR 72830-4419 |
| Mailing Address |
Po Box 738 Clarksville AR 72830-0738 |
| Practice Telephone | 4797545454 |
| Practice Fax Number | 4797545311 |
| Mailing Telephone | 4797545454 |
| Mailing Fax Number | 4797545311 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | C236 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BX INDIVIDUAL PROVIDER # | 59486 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528174554 | Roger Franklin Kennedy | Neurological Surgery | 846 45th Ave Nw, Lot 10, Hazen, ND 58545-9362 | 2006-08-22 |
| 1891303152 | Roger Kennedy | Counselor | 1652 Nw Hughwood Ct, Roseburg, OR 97471-8844 | 2020-07-22 |
| 1417296104 | Roger Lee Kennedy Jr. | Pharmacist | 1404 E Avalon Ave, Tuscumbia, AL 35674-1773 | 2013-01-31 |
| Street Address |
1100 E POPLAR ST |
| City | CLARKSVILLE |
| State | AR |
| Zip Code | 72830-4419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134116049 | Johnson Regional Medical Center | General Acute Care Hospital | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2005-10-05 |
| 1609259753 | East Arkansas Emergency Physicians, Pllc | Emergency Medicine | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2015-07-08 |
| 1205226925 | Jesalyn Dove Wilson | Physician Assistant | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2015-02-02 |
| 1568704765 | Arkansas Em-i Byrne Medical Services, Pa | Physician Assistant | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2013-03-26 |
| 1871835678 | Will Spada Creek Emergency Physicians | Emergency Medicine | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2013-03-20 |
| 1952643686 | Spada Creek Emergency Physicians, LLC | Emergency Medicine | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2013-03-20 |
| 1013255777 | Access Family Medicine, Inc. | Clinic/Center | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2013-01-30 |
| 1447597265 | Johnson Regional Medical Center | Hospitalist | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2013-01-14 |
| 1750635249 | Nola Diane Hays | Nurse Practitioner | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2012-11-05 |
| 1710251418 | Laurie Smith Fisher, M.d., Inc | Clinic/Center | 1100 E Poplar St, Clarksville, AR 72830-4419 | 2012-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649737545 | Marilyn Elaine Laster | Pharmacist | 211 East Main St, Clarksville, AR 72830 | 2019-02-27 |
| 1083186431 | Kayla Chinchilla | Counselor | 106 Cherokee Lane, Clarksville, AR 72830 | 2018-12-26 |
| 1669995619 | Karla D Snow | Case Manager/Care Coordinator | 718 Brown Street, Clarksville, AR 72830 | 2017-07-21 |
| 1811426232 | Netscript Telemedicine Solutions | Family Medicine | 235 Cr 3520, Clarksville, AR 72830 | 2017-06-08 |
| 1275882060 | Shay Morgan | Dietitian, Registered | 1100 East Poplar Street, Clarksville, AR 72830 | 2012-09-07 |
| 1518111566 | Melisa Leann Traylor | Case Manager/Care Coordinator | 522 Mill Road, Clarksville, AR 72830 | 2008-11-04 |
| 1669635280 | Family Foot Clinic | Podiatrist | 203 Sevier St, Clarksville, AR 72830 | 2008-07-03 |
| 1891969721 | Scott Lee Landis | Counselor | 522 Mills Rd., Clarksville, Ar, AR 72830 | 2008-04-22 |
| 1437364684 | Snider Family Chiropractic Clinic | Chiropractor | 1012 Poplar St., Clarksville, AR 72830 | 2007-05-11 |
| 1376765917 | Jones Speech Therapy | Speech-Language Pathologist | 1312 North Harmony Road, Clarksville, AR 72830 | 2007-05-03 |
| Find all providers in zip 72830 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346605367 | Elizabeth Upton | Nurse Anesthetist, Certified Registered | 2806 Pam Dr, Clarksville, TN 37043-6238 | 2015-12-17 |
| 1639109093 | Lois J Bernard | Nurse Anesthetist, Certified Registered | 1734 Memorial Dr, Clarksville, TN 37043-4550 | 2006-07-03 |
| 1609818798 | Deanna Williams | Nurse Anesthetist, Certified Registered | 1990 Cane Brake Rd, Clarksville, TN 37040-6015 | 2006-06-12 |
| 1336110865 | Bradley Richardson | Nurse Anesthetist, Certified Registered | 735 Courtland Ave, Clarksville, TN 37043-5657 | 2006-02-01 |
| 1942858394 | Warfield Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 280 Warfield Blvd, Clarksville, TN 37043-1828 | 2019-08-29 |
| 1174937320 | Daisy Tambe | Nurse Anesthetist, Certified Registered | 980 Professional Park Dr, Ste C, Clarksville, TN 37040-5251 | 2014-06-16 |
| 1841569316 | Kristina E Conroy | Nurse Anesthetist, Certified Registered | 1817a Madison St, Ste 1, Clarksville, TN 37043-2930 | 2011-12-29 |
| 1033412622 | H Danielle Adams | Nurse Anesthetist, Certified Registered | 1817a Madison St, Ste 1, Clarksville, TN 37043-2930 | 2010-12-21 |
| 1588967103 | Jana Geeslin | Nurse Anesthetist, Certified Registered | 1817a Madison St, Ste 1, Clarksville, TN 37043-2930 | 2010-12-21 |
| 1275859787 | Clarksville Anesthesia LLC | Nurse Anesthetist, Certified Registered | 132 Hillcrest Dr, Clarksville, TN 37043-5000 | 2010-04-09 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 72830 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.