Active NPI
Kacee Reynolds, APRN
- Family Nurse Practitioner
- Star City, AR
National Provider Identifier
1730841883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 213443
- Practice address
- 110 N Drew St
Star City, AR 71667-5704 - Phone
- (870) 628-5110
- Fax
- (855) 854-6281
- NPI assigned
- Oct 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 213443 | AR | Primary |
Addresses
Primary practice location
110 N Drew St
Star City, AR 71667-5704
Mailing address
PO Box 509
Dermott, AR 71638-0509
Phone (870) 538-5414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 236266758 | Medicaid | AR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kacee.reynolds@mshi.eclinicaldirectplus.com |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icarepro of Texas, PA | Single Specialty | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1730841883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 509",
"city": "DERMOTT",
"state": "AR",
"postal_code": "716380509",
"telephone_number": "870-538-5414",
"fax_number": "870-538-5412"
},
{
"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": "870-628-5110",
"fax_number": "855-854-6281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KACEE",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-06",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "213443",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "236266758",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kacee.reynolds@mshi.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "110 N Drew St",
"city": "Star City",
"state": "AR",
"country_code": "US",
"postal_code": "716675704",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Star City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.