Active NPI
Kyla Warnick
- Psychologist
- Russellville, AR
National Provider Identifier
1114525284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 202100
- Practice address
- 1310 W B St
Russellville, AR 72801-2802 - Phone
- (479) 857-5036
- Fax
- (479) 974-2010
- NPI assigned
- Oct 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 202100 | AR | Primary |
Addresses
Primary practice location
1310 W B St
Russellville, AR 72801-2802
Mailing address
1705 Skyline Dr
Russellville, AR 72802-9072
Phone (479) 857-5036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202100 | AR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1114525284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 SKYLINE DR",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728029072",
"telephone_number": "479-857-5036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 W B ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728012802",
"telephone_number": "479-857-5036",
"fax_number": "479-974-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARNICK",
"first_name": "KYLA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-12",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AR",
"license": "202100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.