Kelly R. McCarty, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

123726 Issued in AR

Practice address

5872 W Bannister Dr
Fayetteville, AR 72704-6536

Phone

(479) 276-0939

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ketamine and IV Therapy Clinic of Nwa LLCGroup PAC ID 6507308707, 12 clinicians

Pure Balance of Nwa PLLCGroup PAC ID 6901344928, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ketamine and IV Therapy Clinic of Nwa LLC

  dba ascend wellness

  • Certified Registered Nurse Anesthetist
  • Lowell, AR
  • NPI 1609654847

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Pure Balance of Nwa PLLC

  • Psychiatry Physician
  • Rogers, AR
  • NPI 1073359931
  Medicare reassignment Care Compare group NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1821619370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5872 W BANNISTER DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046536",
            "telephone_number": "479-276-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5872 W BANNISTER DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046536",
            "telephone_number": "479-276-0939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3608 W Southern Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588013",
            "country_code": "US",
            "telephone_number": "479-633-7052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "KELLY",
        "middle_name": "R.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "123726",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "123726",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "123726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Marie-Ivey McAnally
• Sara E McBee, DO
• Rubie McBride
• Dallas McCabe
• Danny McCarty, LAC
• Scott McCarty, PH.D.
• Amanda Nicole McCasland, PA-C
• Brooke McCaslin
• Kendra Jean McCaslin
• Patricia McCauley, RN

• Psychiatric/Mental Health Nurse Practitioner in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.