Kacy V. Enloe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

979 Issued in AR

Practice address

1695 E Rainforest Rd
Fayetteville, AR 72703-5385

Phone

(479) 445-6460

NPI assigned

Aug 30, 2018

Last updated

May 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kacyenloe@wrms.allscriptsdirect.net
• Direct secure messaging: kenloe28539@washingtonregional.direct-ci.com
• Direct secure messaging: rollerweightlossandadvancedsurgery.kacyenloe@118248.advancedmd-direct.com

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.

• Washington Regional Medical System

  dba Northwest Arkansas Neuroscience Institute

  • Neurological Surgery Physician
  • Fayetteville, AR
  • NPI 1104097500
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Roller Weight Loss Institute,Inc.

  • Specialist
  • Fayetteville, AR
  • NPI 1073743399
  Medicare reassignment
• F&S Physical Therapy, Inc.

  • Physical Therapist
  • Alma, AR
  • NPI 1518936418
  Care Compare group
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Roller Weight Loss Institute Inc

  • Surgery Physician
  • Tulsa, OK
  • NPI 1912446741
  NPD
• Summit Medical Group, PLLC

  dba Seymour Family Physicians

  • Family Medicine Physician
  • Seymour, TN
  • NPI 1720123763
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1922580638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 E RAINFOREST RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035385",
            "telephone_number": "479-651-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 E RAINFOREST RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035385",
            "telephone_number": "479-445-6460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7211 Wellington Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195968",
            "country_code": "US",
            "telephone_number": "865-584-5762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENLOE",
        "first_name": "KACY",
        "middle_name": "V.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3503",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Claire Engelbrecht, IBCLC
• Deborah England, DC
• Kristy A England, OTL
• Shelli B Engle, LMSW
• Connor Taylor English, DPT
• Kathy Alene Ennes, LCSW
• Jared Ennis, MD
• Kimberly Rose Ennis, PT, DPT
• Crystalyn G Enos
• ENT and Allergy Center, PA

• Physician Assistant in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.