KATHRYN RAE DUTTON DNP, AGACNP - NPI 1174017917 - Nurse Practitioner in Malvern, AR

Q: What is Kathryn Dutton's NPI number?

The NPI number for Kathryn Dutton is 1174017917. It was assigned to this individual provider in the NPPES registry on June 15, 2018. The provider is also known as Kathryn Fisher.

Q: What is Kathryn Dutton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Kathryn Dutton was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Kathryn Rae Dutton Dnp, Agacnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHRYN RAE DUTTON DNP, AGACNP (NPI 1174017917) is an individual acute care provider in Malvern, Arkansas, licensed in Arkansas (A005837) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1174017917

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameKATHRYN RAE DUTTONCredential: DNP, AGACNP

Location Address2223 GRANT STMalvern, AR 72104-4700

Mailing Address223 Grant StMalvern, AR 72104-4700 · (479) 783-4672 · Fax (479) 339-8890

Phone(501) 337-9031

Fax(479) 339-8890

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 15, 2018

Last NPPES UpdateApril 23, 20264 updates tracked since enumeration

NPPES CertifiedApril 23, 2026

✔ NPI 1174017917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in AR · A005837

2223 GRANT ST, Malvern, AR 72104

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Other Names 1

Former Name (1)Kathryn Fisher

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathryn Rae Dutton Dnp, Agacnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911251772

PECOS Enrollment IDI20181114000209

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DEBRA WADE APRN

Nurse Practitioner (Psychiatric/Mental Health)