Individual provider Active NPI

Kiley Austin Pennington, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Clinton, AR
National Provider Identifier
1114839511
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
238827 Issued in AR
Practice address
175 Volunteer Pkwy
Clinton, AR 72031-8001
Phone
(501) 745-3388
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 238827 AR Primary

Addresses

Primary practice location

175 Volunteer Pkwy
Clinton, AR 72031-8001

Mailing address

20 CCC Rd
Damascus, AR 72039-8907

Other practice location 1

383 Dave Creek Pkwy
Fairfield Bay, AR 72088-3631
Phone (501) 884-6900

Other names 1

  • Kiley Austin Trudeau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1114839511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CCC RD",
            "city": "DAMASCUS",
            "state": "AR",
            "postal_code": "720398907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 VOLUNTEER PKWY",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720318001",
            "telephone_number": "501-745-3388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "383 Dave Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fairfield Bay",
            "state": "AR",
            "postal_code": "720883631",
            "country_code": "US",
            "telephone_number": "501-884-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "KILEY",
        "middle_name": "AUSTIN",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "238827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KILEY",
            "last_name": "TRUDEAU",
            "middle_name": "AUSTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.