Individual provider Active NPI

Kimberly Marie Williams, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1710699657
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
222867 Issued in AR
Practice address
7001 Rogers Ave Ste 503
Fort Smith, AR 72903-4073
Phone
(479) 769-3400
Fax
(479) 452-0336
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 222867 AR Primary

Addresses

Primary practice location

7001 Rogers Ave Ste 503
Fort Smith, AR 72903-4073

Mailing address

7001 Rogers Ave Ste 503
Fort Smith, AR 72903-4073
Phone (479) 769-3400

Other practice location 1

7001 Rogers Ave Ste 401
Fort Smith, AR 72903-4034
Phone (479) 769-3400

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
I20230227001095 AR Practitioner - Nurse Practitioner 6305219130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, shared by 4 NPIs, 361 clinicians

Practice addresses (Care Compare)

7001 Rogers Ave
Fort Smith, AR 72903-4073

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222867ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Jan 1, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Feb 20, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Feb 20, 2023 Accepting new patients

Locations

7001 Rogers Ave
Ste 401A
Fort Smith, AR 72903
Phone (479) 314-4650

2713 S 74th St
Ste 401
Fort Smith, AR 72903
Phone (479) 452-7324

7001 Rogers Ave
Ste 403
Fort Smith, AR 72903
Phone (479) 573-3101

7001 Rogers Ave
Ste 503
Fort Smith, AR 72903
Phone (479) 769-3400

7001 Rogers Ave
Ste 401
Fort Smith, AR 72903
Phone (479) 314-4650

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1710699657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 503",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034073",
            "telephone_number": "479-769-3400",
            "fax_number": "479-452-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 503",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034073",
            "telephone_number": "479-769-3400",
            "fax_number": "479-452-0336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7001 Rogers Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729034034",
            "country_code": "US",
            "telephone_number": "479-769-3400",
            "fax_number": "479-452-0336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "222867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.