Stephen M. Killingsworth, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

C6433 Issued in AR

Practice address

200 N Quanah Ave
Russellville, AR 72801-2762

Phone

(479) 890-0368

Fax

(479) 890-7368

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: skillingsworth@rvent.gwaydirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/1a399bfe-f78b-4bd3-b22b-301d9fc9736a/

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1013985969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N QUANAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012762",
            "telephone_number": "479-890-0368",
            "fax_number": "479-890-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N QUANAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012762",
            "telephone_number": "479-890-0368",
            "fax_number": "479-890-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLINGSWORTH",
        "first_name": "STEPHEN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AR",
            "license": "C6433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BCBS",
            "identifier": "52878",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105349001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent D Bartlett DDS PA
• Douglas Kerin, MD
• Gina Anne Kersh, RDN, LD
• Crystal Lynn Kibler, DNP, APRN, FNP-C
• Janice Nicole Kile, PHARMD
• Kimberly Wells Counseling LLC
• Sarah Kimbrow
• Aly Kinder
• Chelsey King, RECOVERY ASSISTANT
• Amy Lynn Kirby

• Otolaryngology/Facial Plastic Surgery Physician in Russellville, AR
• Providers in Russellville, AR by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.