Individual provider Active NPI

Kathryn Rae Dutton, DNP, AGACNP

  • Acute Care Nurse Practitioner
  • Malvern, AR
National Provider Identifier
1174017917
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A005837 Issued in AR
Practice address
2223 Grant St
Malvern, AR 72104-4700
Phone
(501) 337-9031
Fax
(479) 339-8890
NPI assigned
Jun 15, 2018
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A005837 AR Primary

Addresses

Primary practice location

2223 Grant St
Malvern, AR 72104-4700

Mailing address

223 Grant St
Malvern, AR 72104-4700
Phone (479) 783-4672

Other names 1

  • Kathryn Fisher Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181114000209 AR Practitioner - Nurse Practitioner 7911251772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appello Health and Wellness Clinic LLCGroup PAC ID 3971043290, 76 clinicians

Practice addresses (Care Compare)

2223 Grant St
Malvern, AR 72104-4700
Phone (501) 337-9031

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Appello Health and Wellness Clinic, LLC CurrentSince Feb 8, 2026 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 1, 2018 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 1, 2018 Accepting new patients

Locations

2223 Grant St
Malvern, AR 72104
Phone (501) 337-9031

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 636-0200

Interoperability endpoints

  • Direct secure messaging: kdutton50016@washingtonregional.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1174017917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 GRANT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044700",
            "telephone_number": "479-783-4672",
            "fax_number": "479-339-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 GRANT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044700",
            "telephone_number": "501-337-9031",
            "fax_number": "479-339-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "KATHRYN",
        "middle_name": "RAE",
        "credential": "DNP, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A005837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "FISHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.