Andrea King

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

A005839 Issued in AR

Practice address

2719 SE I St
Bentonville, AR 72712-3996

Phone

(543) 747-9273

NPI assigned

Oct 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bentonville Pediatrics

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1356319164
  NPD (past)
• Northwest Arkansas Immunization

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1386944791
  NPD (past)

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1386129898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CRESSWELL LN",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727145225",
            "telephone_number": "405-246-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 SE I ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123996",
            "telephone_number": "543-747-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "AR",
            "license": "A005839",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A005839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BJ Kidwell
• David Neal Kilgo, R.PH
• April E Kilgore, MD
• Steven Dale Kimbrough, D.M.D.
• Josiah David Kimler
• Deborah L King, DDS
• Rebecca King
• Savannah Joy King, PA-C
• Sydney Kinser
• Sandra Kinsey, PD

• Pediatric Nurse Practitioner in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatric Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.