Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kasilynn Alese Shaddy

Individual provider Nurse Practitioner · NPI 1144836909

Kasilynn Alese Shaddy is a Nurse Practitioner in Springdale, Arkansas. Qualified in 2020, 6 years ago. Practices with Premier Family Health Care LLC, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arkansas.

Years since qualifying
6
Licensed in
AR
In the registry since
2020
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Practice location Address checks out

3300 W Sunset Ave
Springdale, AR 72762-4950
Phone: (479) 717-7089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 125710 (AR)

Record details

NPI number1144836909
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 17, 2020
Last updated in NPPESSeptember 17, 2020
Certification dateSeptember 17, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Premier Family Health Care Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Springdale