Individual provider Active NPI

Kayla Evan Kriesel, APRN

  • Family Nurse Practitioner
  • Russellville, AR
National Provider Identifier
1821859810
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
227096 Issued in AR
Practice address
2500 W Main St
Russellville, AR 72801-2533
Phone
(479) 219-9913
Fax
(479) 219-9914
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 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 227096 AR Primary

Addresses

Primary practice location

2500 W Main St
Russellville, AR 72801-2533

Mailing address

1507 Lands End PT S
Russellville, AR 72802-8800
Phone (479) 857-3178

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
I20240307003880 AR Practitioner - Nurse Practitioner 9638515067 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227096ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Obstetrics and Gynecology, P. a. CurrentSince May 15, 2025 Accepting new patients

Locations

2500 W Main St
Russellville, AR 72801
Phone (479) 219-9913

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24926/brand/1/csg/1/fhir/r4

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1821859810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 LANDS END PT S",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728028800",
            "telephone_number": "479-857-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012533",
            "telephone_number": "479-219-9913",
            "fax_number": "479-219-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIESEL",
        "first_name": "KAYLA",
        "middle_name": "EVAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "227096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.