EDMUND KENNEDY (NPI# 1902075435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902075435 |
| Entity Type | Individual |
| Full Name | EDMUND KENNEDY |
| Credential | MD |
| Practice Address |
1501 S Waldron Rd Ste 107 Fort Smith AR 72903-2574 |
| Mailing Address |
Po Box 402319 Atlanta GA 30384-2319 |
| Practice Telephone | 4795737980 |
| Practice Fax Number | 4795737981 |
| Mailing Telephone | 4797097399 |
| Mailing Fax Number | 4797097053 |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2010-08-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | R3286 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100055840A | 05 | |
| AR | 107739001 | 05 |
| Street Address |
1501 S WALDRON RD STE 107 |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-2574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629065685 | Russell B Branum | Internal Medicine | 1501 S Waldron Rd, Ste 202, Fort Smith, AR 72903-2574 | 2005-10-04 |
| 1790391969 | Sarah Crawford | Occupational Therapist | 1501 S Waldron Rd, Fort Smith, AR 72903-2574 | 2020-09-22 |
| 1467062695 | Tyler Wayne Tustin | Occupational Therapist | 1501 S Waldron Rd, Fort Smith, AR 72903-2574 | 2020-08-03 |
| 1144676214 | Kids Choice Fort Smith | Dentist | 1501 S Waldron Rd, Suite 200, Fort Smith, AR 72903-2574 | 2016-05-09 |
| 1477843803 | Ft Smith Hma Pbc Management, LLC | Otolaryngology | 1501 S Waldron Rd, Suite 107, Fort Smith, AR 72903-2574 | 2011-04-19 |
| 1114218542 | Ft Smith Hma Physician Management, LLC | Nurse Practitioner | 1501 S Waldron Rd, Suite 100, Fort Smith, AR 72903-2574 | 2011-04-19 |
| 1679803738 | Smile Help Dental | Clinic/Center | 1501 S Waldron Rd, Suite 208, Fort Smith, AR 72903-2574 | 2010-01-12 |
| 1598936460 | Sparks Medical Foundation | Durable Medical Equipment & Medical Supplies | 1501 S Waldron Rd, Ste 107, Fort Smith, AR 72903-2574 | 2008-03-18 |
| 1801065453 | Sparks Regional Medical Center | Durable Medical Equipment & Medical Supplies | 1501 S Waldron Rd, Ste. 100, Fort Smith, AR 72903-2574 | 2008-02-28 |
| 1790880797 | Sparks Medical Foundatin | Durable Medical Equipment & Medical Supplies | 1501 S Waldron Rd, Ste 100, Fort Smith, AR 72903-2574 | 2006-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134608961 | Baptist Health Services | Otolaryngology | 520 Towson Ave, Suite A, Fort Smith, AR 72901 | 2018-08-13 |
| 1376833707 | Ft Smith Hma Pbc Management, LLC | Otolaryngology | 1500 Dodson Ave, Suite 220, Fort Smith, AR 72901-5182 | 2011-04-19 |
| 1477843803 | Ft Smith Hma Pbc Management, LLC | Otolaryngology | 1501 S Waldron Rd, Suite 107, Fort Smith, AR 72903-2574 | 2011-04-19 |
| 1205065919 | Edgar Allen Gedosh | Otolaryngology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2009-07-02 |
| 1073693909 | Gary R. Highfill | Otolaryngology | 1500 Dodson Ave, Ste 260, Fort Smith, AR 72901-5182 | 2006-10-16 |
| 1053320358 | Paul I Wills | Otolaryngology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2006-08-05 |
| 1174547988 | Michael A Marsh | Otolaryngology | 7805 Phoenix Ave, Fort Smith, AR 72903-5091 | 2006-07-26 |
| 1689694002 | James I Bradburn | Otolaryngology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2006-07-20 |
| 1619995248 | Michael P Gwartney | Otolaryngology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992125850 | White River Health System, Inc. | Otolaryngology | 501 Virginia Dr Ste A, Batesville, AR 72501-7317 | 2014-04-18 |
| 1437590080 | John R Sims | Otolaryngology | 8901 Carti Way Ste 201, Little Rock, AR 72205-6523 | 2013-07-11 |
| 1467726539 | William Rolland Eddington | Otolaryngology | 2564 Greene Road 739, Paragould, AR 72450-8859 | 2012-03-06 |
| 1558650960 | Graham Michael Strub | Otolaryngology | 1 Childrens Way # 836, Little Rock, AR 72202-3500 | 2011-04-06 |
| 1346478484 | Family Ent & Sinus Center of Harrison, P.a. | Otolaryngology | 1401 Mccoy Drive, Harrison, AR 72601-2417 | 2009-06-28 |
| 1376760215 | Robert Vernon Borg | Otolaryngology | 214 Leigh Cir, Hot Springs, AR 71901-7758 | 2007-04-20 |
| 1225170376 | Jason A Smith | Otolaryngology | 4901 Fairway Ave, Suite C, North Little Rock, AR 72116-6923 | 2007-02-13 |
| 1689730459 | Gordon Carl Shipp | Otolaryngology | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2006-12-28 |
| 1275605206 | Sharon Marie Tomaski | Otolaryngology | 620 W Grove St Ste 201, El Dorado, AR 71730-4425 | 2006-11-14 |
| 1801986393 | Felicia Johnson | Otolaryngology | 601 W Maple Ave Ste 213, Springdale, AR 72764-5397 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
| City | FORT SMITH |
| Zip Code | 72903 |
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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.