1. Home
  2. Directory
  3. Arkansas
  4. Little Rock
  5. Clinic Center
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KENDALL D. WAGNER, M.D., PLLC
NPI 1528721271
Clinic/Center - Primary Care in Little Rock, AR

Active since October 20, 2021
500 S UNIVERSITY AVE STE 702, LITTLE ROCK, AR 72205(501) 766-6311(472) 227-2345 Get Directions Write a Review

NPPES record last updated: September 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 13, 2026, Oct 20, 2021 (2 updates tracked since 2021).

About Kendall D. Wagner, M.d., Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDALL D. WAGNER, M.D., PLLC (NPI 1528721271) is a healthcare organization registered as a primary care in Little Rock, Arkansas and active in the NPI registry since October 2021. The organization lists Kendall Darren Wagner, Physician, as its authorized official.

NPPES Registry Identity

NPI1528721271
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameKENDALL D. WAGNER, M.D., PLLC
Location Address500 S UNIVERSITY AVE STE 702Little Rock, AR 72205-5309
Mailing Address46 Miramont CirLittle Rock, AR 72223-3301 · (501) 766-6311 · Fax (479) 227-2345
Phone(501) 766-6311
Fax(472) 227-2345
Organization SubpartNo
Authorized OfficialKendall Darren WagnerPhysician · (501) 766-6311
Enumeration DateOctober 20, 2021
Last NPPES UpdateSeptember 13, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2026
✔ NPI 1528721271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
500 S UNIVERSITY AVE STE 702, Little Rock, AR 72205
Open in Google Maps ↗

Other Identifiers 1

Medicaid202855001AR

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendall D. Wagner, M.d., Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20211122000266Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kendall D. Wagner, M.D., PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kendall Wagner, M.D.
Internal Medicine
NPI 1699091264
500 S UNIVERSITY AVE STE 702
Little Rock, AR 72205
(501) 766-6311
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendall D. Wagner, M.D., PLLC's NPI number?

The NPI number for Kendall D. Wagner, M.D., PLLC is 1528721271. It was assigned to this organization in the NPPES registry on October 20, 2021.

Where is Kendall D. Wagner, M.D., PLLC located?

Kendall D. Wagner, M.D., PLLC is located at 500 S University Ave Ste 702, Little Rock, AR 72205. The listed phone number is (501) 766-6311.

What is Kendall D. Wagner, M.D., PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Kendall D. Wagner, M.D., PLLC enrolled in Medicare?

Yes. Kendall D. Wagner, M.D., PLLC is registered in the Medicare PECOS enrollment system.

When is Kendall D. Wagner, M.D., PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Kendall D. Wagner, M.D., PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Kendall D. Wagner, M.D., PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kendall D. Wagner, M.D., PLLC was last updated on September 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.