Individual provider Active NPI

Julia Killingsworth, M.D.

  • Pediatrics Physician
  • Little Rock, AR
National Provider Identifier
1457714123
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-12078 Issued in AR
Practice address
1 Childrens Way # 512-8
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-12078 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-8
Little Rock, AR 72202-3500

Mailing address

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

Other names 1

  • Julia Lyon 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190611000222 AR Practitioner - Pediatric MedicinePractitioner - Hospitalist 5991097834 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children's Hospital CurrentSince Jul 1, 2019 Accepting new patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2019 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2019 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
University of Arkansas for Medical Sciences Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Arkansas Children's Medical Group PLLC Pediatrics Past Accepting new patients
Arkansas Childrens Northwest, Inc. Past Accepting new patients

Locations

1 Childrens Way
#664
Little Rock, AR 72202
Phone (501) 364-2505

1 Childrens Way
#512
Little Rock, AR 72202

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

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

1 Childrens Way
#5128
Little Rock, AR 72202
Phone (501) 364-4361

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

Interoperability endpoints

  • FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

Organizations & group practices 9

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1457714123",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-8",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLINGSWORTH",
        "first_name": "JULIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-12078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "LYON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.