Individual provider Active NPI

McKenna M Wilkerson, APRN

  • Family Nurse Practitioner
  • Star City, AR
National Provider Identifier
1649012360
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
228033 Issued in AR
Practice address
110 N Drew St
Star City, AR 71667-5704
Phone
(870) 625-5110
Fax
(855) 854-6281
NPI assigned
Jun 12, 2024
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 228033 AR Primary

Addresses

Primary practice location

110 N Drew St
Star City, AR 71667-5704

Mailing address

342 Highway 425 S Ste a
Monticello, AR 71655-4612
Phone (870) 942-3000

Other identifiers 1

IdentifierTypeStateIssuer
228033OtherARLICENSE

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
I20240715001664 AR Practitioner - Nurse Practitioner 1759826746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainline Health Systems IncGroup PAC ID 5193785590, 55 clinicians

Practice addresses (Care Compare)

110 N Drew St
Star City, AR 71667-5704
Phone (870) 628-5110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228033ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainline Health Systems, Inc Current Accepting new patients
Mainline Health Systems, Inc CurrentSince May 3, 2024 Accepting new patients
Mainline Health Systems, Inc CurrentSince May 3, 2024 Accepting new patients
Mainline Health Systems, Inc Past Accepting new patients

Locations

300 S School St
Dermott, AR 71638
Phone (870) 538-3355

579 E Beouff St
Eudora, AR 71640
Phone (870) 355-2512

342 Highway 425 S
Ste A
Monticello, AR 71655

535 Jordan Dr
Monticello, AR 71655
Phone (870) 367-6246

110 N Drew St
Star City, AR 71667
Phone (870) 628-5110

400 E Arkansas St
Rm E3
Star City, AR 71667
Phone (650) 419-2810

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1649012360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HIGHWAY 425 S STE A",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554612",
            "telephone_number": "870-942-3000",
            "fax_number": "870-942-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N DREW ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675704",
            "telephone_number": "870-625-5110",
            "fax_number": "855-854-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MCKENNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "228033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "228033",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Star City, AR

Sources for this page

Verify at the official NPI Registry.