Individual provider Active NPI

Kimberly Martin Cudworth, APRN

  • Family Nurse Practitioner
  • Harrison, AR
National Provider Identifier
1760155121
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
216292 Issued in AR
Practice address
1002 North Spring Street
Harrison, AR 72601-2918
Phone
(870) 741-6373
Fax
(870) 741-5102
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 216292 AR Primary

Addresses

Primary practice location

1002 North Spring Street
Harrison, AR 72601-2918

Mailing address

PO Box 1060
Marshall, AR 72650-1060
Phone (870) 448-5733

Other identifiers 1

IdentifierTypeStateIssuer
280000758MedicaidAR

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
I20220106001376 AR Practitioner - Nurse Practitioner 7911398649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Mountain Rural Health Center, IncGroup PAC ID 3870401722, 53 clinicians

Practice addresses (Care Compare)

1002 N Spring St
Harrison, AR 72601-2918
Phone (870) 741-6373

Hospital & facility affiliations

  • North Arkansas Regional Medical Center Hospital, Harrison, AR, CCN 040017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216292ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter County Regional Hospital, Inc Current Accepting new patients
Boston Mountain Rural Health Center Inc. CurrentSince Aug 4, 2025 Accepting new patients
Boston Mountain Rural Health Center, Inc CurrentSince Aug 4, 2025 Accepting new patients
Baxter County Regional Hospital Inc CurrentSince Nov 1, 2021 Accepting new patients
Boston Mountain Rural Health Center Inc Current Accepting new patients
Baxter County Regional Hospital, Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

1002 N Spring St
Harrison, AR 72601
Phone (870) 741-6373

115 Orendorff Ave
Harrison, AR 72601
Phone (870) 741-3438

1420 Highway 62 65 N
Ste 1
Harrison, AR 72601
Phone (870) 741-3600

934 N Gaskill St
Huntsville, AR 72740
Phone (479) 738-5500

Organizations & group practices 6

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 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": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1760155121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501060",
            "telephone_number": "870-448-5733",
            "fax_number": "870-741-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 NORTH SPRING STREET",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012918",
            "telephone_number": "870-741-6373",
            "fax_number": "870-741-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDWORTH",
        "first_name": "KIMBERLY",
        "middle_name": "MARTIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "216292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280000758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.