Individual provider Active NPI

Kyle Cliffton Dennis, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Smith, AR
National Provider Identifier
1891807947
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C01542 Issued in AR
Practice address
2910 Jenny Lind Rd
Fort Smith, AR 72901-6735
Phone
(479) 785-2555
Fax
(479) 785-3555
NPI assigned
Aug 31, 2006
Last updated
Jun 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C01542 AR Primary

Addresses

Primary practice location

2910 Jenny Lind Rd
Fort Smith, AR 72901-6735

Mailing address

PO Box 11286
Fort Smith, AR 72917-1286
Phone (479) 785-2555

Other identifiers 2

IdentifierTypeStateIssuer
159007001MedicaidAR
200073830AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000888 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850326612 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Anesthesia PAGroup PAC ID 6901965276, 9 clinicians
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

3601 S 79TH St
Fort Smith, AR 72903-6255
Phone (479) 785-2555

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C01542ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Anesthesia PA CurrentSince Oct 1, 2008 Accepting new patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2024 Accepting new patients
Arkansas Health Group CurrentSince May 9, 2022 Accepting new patients
Western Arkansas Anesthesiology Associates P.a. CurrentSince Apr 1, 2022 Accepting new patients
Ans Services of Arkansas PA CurrentSince Dec 1, 2023 Accepting new patients
Western Arkansas Obstetric Anesthesia LLC CurrentSince Apr 1, 2022 Accepting new patients
Arkansas Health Group CurrentSince May 9, 2022 Accepting new patients
River Valley Anesthesia Associates, P. a. Past Accepting new patients

Locations

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

3601 S 79th St
Fort Smith, AR 72903
Phone (479) 314-4723

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1891807947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11286",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171286",
            "telephone_number": "479-785-2555",
            "fax_number": "479-785-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 JENNY LIND RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729016735",
            "telephone_number": "479-785-2555",
            "fax_number": "479-785-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "KYLE",
        "middle_name": "CLIFFTON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C01542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159007001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200073830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.