Individual provider Active NPI

Kelsi Frederick, CNP

  • Pediatric Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1659140309
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
121586 Issued in AR
Practice address
1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 121586 AR Primary

Addresses

Primary practice location

1 Childrens Way # 653
Little Rock, AR 72202-3500

Mailing address

3525 Western Gales Dr
Jonesboro, AR 72405-9197
Phone (918) 803-2079

Other practice location 1

4301 W Markham St
Little Rock, AR 72205-7101
Phone (918) 803-2079

Other names 1

  • Kelsi Jo Davison 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250116002860 AR Practitioner - Nurse Practitioner 2769910819 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Dec 20, 2024 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Childrens Professional Services Organization LLC CurrentSince Jul 1, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Dec 20, 2024 Accepting new patients
Arkansas Childrens Hospital CurrentSince Dec 20, 2024 Accepting new patients
Arkansas Children's Hospital CurrentSince Dec 20, 2024 Accepting new patients
University of Arkansas for Medical Sciences Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

520 Carson St
Jonesboro, AR 72401
Phone (870) 336-2175

1 Childrens Way
Ste 854
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
#854
Little Rock, AR 72202

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

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Ste 783
Little Rock, AR 72205
Phone (501) 603-1278

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

Organizations & group practices 8

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1659140309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 WESTERN GALES DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059197",
            "telephone_number": "918-803-2079"
        },
        {
            "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": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "918-803-2079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "KELSI",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "121586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSI",
            "last_name": "DAVISON",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.