Individual provider Active NPI

Bonnie Ellen Kitchen, ACPNP

  • Pediatric Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1396907259
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
A01667ANP Issued in AR
Practice address
1 Childrens Way # 653
Little Rock, AR 72202
Phone
(501) 364-1100
Fax
(501) 364-2963
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X A01667ANP AR Primary

Addresses

Primary practice location

1 Childrens Way # 653
Little Rock, AR 72202

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

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
I20160322002210 AR Practitioner - Nurse Practitioner 8921305749 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A01667ANPARMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Feb 1, 2016 Accepting new patients
Arkansas Childrens Hospital CurrentSince Feb 1, 2016 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 1, 2016 Accepting new patients
Arkansas Children'S Hospital CurrentSince Feb 1, 2016 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1396907259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72202",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHEN",
        "first_name": "BONNIE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "ACPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A01667ANP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.