Active NPI
Kimberly Ferris, RN
- Registered Nurse
- Fayetteville, AR
National Provider Identifier
1538630645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 12995476
- Practice address
- 3715 N Business Dr Ste 202
Fayetteville, AR 72703-5288 - Phone
- (479) 582-0777
- Fax
- (479) 582-0778
- NPI assigned
- Dec 16, 2018
- Last updated
- Dec 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 12995476 | CT | Primary |
Addresses
Primary practice location
3715 N Business Dr Ste 202
Fayetteville, AR 72703-5288
Mailing address
3715 N Business Dr Ste 202
Fayetteville, AR 72703-5288
Phone (479) 582-0777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12995476 | CT | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trestletree, LLC | Registered Nurse | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544918400000",
"number": "1538630645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 N BUSINESS DR STE 202",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727035288",
"telephone_number": "479-582-0777",
"fax_number": "479-582-0778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 N BUSINESS DR STE 202",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727035288",
"telephone_number": "479-582-0777",
"fax_number": "479-582-0778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRIS",
"first_name": "KIMBERLY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "12995476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.