Kimberly Nicole Alexander, RN
Individual provider Active NPI Registered Nurse · Fayetteville, AR
NPI 1821847294 · NPPES record last updated May 16, 2024
Key facts
- NPI
- 1821847294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 223368 (AR)
- Practice address
- 3215 N Northhills Blvd
Fayetteville, AR 72703-4424 - Phone
- (479) 463-1000
- NPI assigned
- May 16, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of Arkansas College of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Anesthesia of Arkansas Professional Corporation
Renew Medical Group of Arkansas LTD
Practice addresses (Care Compare)
3215 N N Hills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-1000
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000
Hospital & facility affiliations
- Mercy Hospital Northwest Arkansas
- Washington Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR, OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241118000485 | AR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6204360944 | Reassigns benefits to 2 organizations |
| I20260611001697 | OR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6204360944 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 223368 | AR | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Anesthesia of Arkansas Professional Corporation | Current |
Accepting new patients | |
| Renew Medical Group of Arkansas LTD | Current |
Accepting new patients |
Locations
3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000
7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600
2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 223368 | AR | Yes |
Addresses
Primary practice location
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Mailing address
2811 N University Ave
Little Rock, AR 72207-2739
Phone (479) 353-7588
Other providers in Fayetteville, AR
- Yasmin Al-Atrache
- Al-Murtadha Al-Gahmi
- Christen Anthony Alaniz
- Bernadette A. Alberty
- Lane E Alderson
- Travis Alexander
- Whitney Smith Alexander
- Alexis Racheotes DC PLLC Sports Chiropractic & Acupuncture
- Alexis Racheotes, DC PLLC Sports Chiropractic & Acupuncture
- Jade Robert Alfasi
All providers in Fayetteville, AR · Registered Nurse in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.