Kasilynn Alese Shaddy

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

125710 Issued in AR

Practice address

3300 W Sunset Ave
Springdale, AR 72762-4950

Phone

(479) 717-7089

NPI assigned

Sep 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Family Health Care LLCGroup PAC ID 8820535545, 7 clinicians

Urgent Team of Arkansas Physicians LLCGroup PAC ID 1850539198, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25086/brand/1/csg/1/fhir/r4

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.

• Premier Family Health Care LLC

  • Primary Care Clinic/Center
  • Siloam Springs, AR
  • NPI 1558102228

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Searcy, AR
  • NPI 1992041370
  Medicare reassignment Care Compare group
• Karas Family Walk in Clinic

  • Primary Care Clinic/Center
  • Fayetteville, AR
  • NPI 1134542434
  Medicare reassignment NPD
• Premier Family Health Care, a Professional Corporation

  • Family Medicine Physician
  • Bakersfield, CA
  • NPI 1467676130
  NPD (past)

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

• Siloam Springs Arkansas Hospital Company LLC

  • General Acute Care Hospital
  • Siloam Springs, AR
  • NPI 1902051816
  Care Compare affiliation

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1144836909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W SUNSET AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727624950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W SUNSET AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727624950",
            "telephone_number": "479-717-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDY",
        "first_name": "KASILYNN",
        "middle_name": "ALESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "125710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Servy, M.D.
• Sabrina I Settles, CNMT
• Sewell Healthwise Chiropractic P.a.
• Mark Andrew Sewell, D.C.
• Regina Kay Sewell, D.C.
• Sarah Shaddy
• Carol Lynn Shafer, RN
• Alexandria Nicole Shannon
• Aneet K Sharma, MD, DDS
• Alyssa Shaw, LPC

• Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.
• 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.