Individual provider Active NPI

Kathryn Denyse Hallen, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Smith, AR
National Provider Identifier
1063118156
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
223182 Issued in AR
Practice address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone
(479) 314-6000
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 223182 AR Primary

Addresses

Primary practice location

7301 Rogers Ave
Fort Smith, AR 72903-4100

Mailing address

3319 S 40TH St
Fort Smith, AR 72903-5417
Phone (479) 629-6232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230313000850 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113391228 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
223182ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Obstetric Anesthesia LLC CurrentSince Mar 1, 2023 Accepting new patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2024 Accepting new patients
Western Arkansas Anesthesiology Associates P.a. CurrentSince Mar 1, 2023 Accepting new patients

Locations

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1063118156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 S 40TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035417",
            "telephone_number": "479-629-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLEN",
        "first_name": "KATHRYN",
        "middle_name": "DENYSE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "223182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.