BJ KIDWELL
NPI 1366102253
Nurse Practitioner - Family in Bentonville, AR

Q: What is Bj Kidwell's NPI number?

The NPI number for Bj Kidwell is 1366102253. It was assigned to this individual provider in the NPPES registry on December 20, 2021.

Q: What is Bj Kidwell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Bj Kidwell was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since December 20, 2021PECOS EnrolledAccepts Medicare Assignment

3101 SE 14TH ST, BENTONVILLE, AR 72712(479) 250-1053(479) 250-0923 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2023, Jan 5, 2022, Dec 20, 2021 (3 updates tracked since 2021).

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About Bj Kidwell NPPES

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

BJ KIDWELL (NPI 1366102253) is an individual family provider in Bentonville, Arkansas, licensed in Arkansas (218019) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, is affiliated with Ochsner Lsu Health Monroe, and maintains a secondary practice location in Monroe.

NPPES Registry Identity

NPI1366102253

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameBJ KIDWELL

Location Address3101 SE 14TH STBentonville, AR 72712-4900

Mailing Address3101 Se 14th StBentonville, AR 72712-4900 · (479) 250-1053 · Fax (479) 250-0923

Phone(479) 250-1053

Fax(479) 250-0923

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 20, 2021

Last NPPES UpdateJune 20, 20233 updates tracked since enumeration

NPPES CertifiedJune 20, 2023

✔ NPI 1366102253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in AR · 218019✔ Licensed in LA · 223761

3101 SE 14TH ST, Bentonville, AR 72712

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Secondary Practice Location 1

Location 14864 Jackson StMonroe, LA 71202-6400 · Phone (318) 330-7000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CHRISTUS Health Plan, HMO Louisiana.Insurance ›

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

Bj Kidwell 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 ID7618360884

PECOS Enrollment IDI20220210002023

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

112 services107 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

91 services89 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ochsner Lsu Health Monroe

Acute Care Hospitals · Monroe, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190011

Location4864 Jackson StreetMonroe, LA 71202 · Ouachita County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72712 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 20

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

AMAL K DUDAR PA-C

Physician Assistant