Mr Roger O Kennedy, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Clarksville, Arkansas. He graduated from nursing school in 1977 and has 47 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Johnson Regional Medical Center and his current practice location is
1100 E Poplar St, Clarksville, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(479) 754-5454.
Mr Roger O Kennedy is licensed to practice in Arkansas (license number C236) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1659484848.
Provider's Profile
| Full Name | Mr Roger O Kennedy |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 47 Years |
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| Location | 1100 E Poplar St, Clarksville, Arkansas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Roger O Kennedy graduated from nursing school in 1977
NPI Data:
- NPI Number: 1659484848
- Provider Enumeration Date: 08/15/2006
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 8325236763
- Enrollment ID: I20101229000270
Medical Identifiers
Medical identifiers for Mr Roger O Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659484848 | NPI | - | NPPES |
| 59486 | Other | AR | BX INDIVIDUAL PROVIDER # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | C236 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Johnson Regional Medical Center | 1658360284 | 14 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Roger O Kennedy allows following entities to bill medicare on his behalf.
| Entity Name | Johnson Regional Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396794525
PECOS PAC ID: 1658360284
Enrollment ID: O20040702000283 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Roger O Kennedy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Roger O Kennedy, CRNA
Po Box 738,
Clarksville, AR 72830-0738
Ph: (479) 754-5454 | Mr Roger O Kennedy, CRNA
1100 E Poplar St,
Clarksville, AR 72830-4419
Ph: (479) 754-5454 |
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