MR. ROGER O KENNEDY CRNA
NPI 1659484848
Nurse Anesthetist, Certified Registered in Clarksville, AR

Q: What is Roger Kennedy's NPI number?

The NPI number for Roger Kennedy is 1659484848. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Q: What is Roger Kennedy's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Roger Kennedy was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.

Active since August 15, 2006Accepts Medicare Assignment

1100 E POPLAR ST, CLARKSVILLE, AR 72830(479) 754-5454(479) 754-5311 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Mr. Roger O Kennedy Crna NPPES

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

MR. ROGER O KENNEDY CRNA (NPI 1659484848) is an individual nurse anesthetist, certified registered in Clarksville, Arkansas, licensed in Arkansas (C236) and active in the NPI registry since August 2006. He is a graduate of Other (1977).

NPPES Registry Identity

NPI1659484848

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameMR. ROGER O KENNEDYCredential: CRNA

Location Address1100 E POPLAR STClarksville, AR 72830-4419

Mailing AddressPo Box 738Clarksville, AR 72830-0738 · (479) 754-5454 · Fax (479) 754-5311

Phone(479) 754-5454

Fax(479) 754-5311

Sole ProprietorNo

Medical School CMSOtherGraduated 1977

Enumeration DateAugust 15, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1659484848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in AR · C236

Definition

(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.

1100 E POPLAR ST, Clarksville, AR 72830

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Other Identifiers 2

Medicare ID-Type Unspecified59486AR · Mcr Individual Provider #

Other59486AR · Bx Individual Provider #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Roger O Kennedy Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325236763

PECOS Enrollment IDI20101229000270

Medicare Billing Reassignment

Medicare enrollment records show Roger Kennedy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Johnson Regional Medical Center

0.2 mi

Anesthesiology

1100 E POPLAR ST
Clarksville, AR 72830

Reassigned Medicare billing, Arkansas enrollment
36 clinicians in this Medicare group

NPI 1396794525 (479) 754-5454

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for exam of colon using an endoscope 00812

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72830 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$119.36 typical visit price

range $51.36 – $157.74

Typical copayment $29.84 (range $12.84 – $39.43)

Most-billed visit code 99204

Established Patient

$64.56 typical visit price

range $16.16 – $128.77

Typical copayment $16.14 (range $4.04 – $32.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHNSON REGIONAL MEDICAL CENTER

General Acute Care Hospital