Individual provider Active NPI

Kelley Hinely

  • Family Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1619395811
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AA004049 Issued in AR
Practice address
3873 N Parkview Dr
Fayetteville, AR 72703-6286
Phone
(479) 571-7004
NPI assigned
Apr 3, 2014
Last updated
Apr 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AA004049 AR Primary

Addresses

Primary practice location

3873 N Parkview Dr
Fayetteville, AR 72703-6286

Mailing address

3873 N Parkview Dr
Fayetteville, AR 72703-6286
Phone (479) 571-7004

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
I20150205002200 AR Practitioner - Nurse Practitioner 4284959693 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Karas Family Walk in ClinicGroup PAC ID 4688899883, 8 clinicians

Practice addresses (Care Compare)

767 W N St
Fayetteville, AR 72701-1865
Phone (479) 966-5088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AA004049ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Karas Family Walk in Clinic CurrentSince Jan 3, 2015 Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2018 Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2018 Accepting new patients
Karas Family Walk-in Clinic Family Past Accepting new patients

Locations

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

767 W North St
Fayetteville, AR 72701
Phone (479) 521-3600

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

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, 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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1619395811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3873 N PARKVIEW DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036286",
            "telephone_number": "479-571-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3873 N PARKVIEW DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036286",
            "telephone_number": "479-571-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINELY",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AA004049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.