KIERSTIN RENE DAUGHERTY (PA-C) – Surgical Physician Assistant, NPI 1356937593
Surgical Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
627 PHYSICIAN ASSISTANT in AR
Provider Addresses for KIERSTIN RENE DAUGHERTY (PA-C)
5220 NORTHSHORE DR
NORTH LITTLE ROCK, AR 721185297
Phone: (501) 663-6455
Fax: (501) 663-4877
Type: Mailing
4300 Landers Rd
North Little Rock, AR 721172525
Phone: (501) 771-1600
Fax: (501) 955-2252
Type: Location
3127 W 2nd Ct Ste B
Russellville, AR 728014566
Phone: (501) 663-6455
Fax: (501) 663-4877
Type: Location
5 SAINT VINCENT CIR
STE 100
LITTLE ROCK, AR 722055415
Phone: (501) 663-6455
Fax: (501) 663-4877
Type: Mailing
323 E HAWKINS PKWY STE A
LONGVIEW, TX 756058162
Phone: (903) 758-2746
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $237.
Total Amount is formed as General ($237) + Research ($0) + Ownership ($0) = $237.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($103).
Total Amount
$237
General + Research + Ownership
Payments
4
Total payment records
General Amount
$237
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $103 |
| Midsouth Orthopedics Inc. | $99 |
| Amgen Inc. | $34 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220523002210 | I | Physician Assistant | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J7331 | Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg | 480 | 15 | $0 |
| 73562 | X-ray of knee, 3 views | 183 | 134 | $0 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 173 | 71 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 129 | 123 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 124 | 124 | $0 |
Insurance plans in this area (ZIP 72118)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | AR | |
| P O D I A T R Y | AR | |
| Physician Assistant | AR | |
| Orthopedic Surgery | AR | |
| Physician Assistant | AR | |
| Hand Surgery | AR | |
| Orthopedic Surgery, Sports Medicine | AR | |
| Physical Therapist In Private Practice | AR | |
| - | AR | |
| Physician Assistant | AR |
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