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Active NPI 1497263222 Individual Practitioner Male Practitioner

Keith Aniel Russworm , NP

Nurse Practitioner • Pine Bluff, AR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Keith Russworm, NP is a certified Nurse Practitioner practicing in Pine Bluff, AR. With approximately 9 years of clinical experience since completing medical education in 2017, Keith Russworm delivers high-quality medical care to the local community at 1600 W 40TH AVE.

Keith Russworm maintains professional affiliations with Wh Services Arkansas, Llc, Southeast Arkansas Emergency Physicians Llp, Ouachita County Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit with moderate level of medical decision making, emergency department visit for life threatening or functioning severity, emergency department visit with low level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1600 W 40th Ave

Pine Bluff, AR 716036301

Telephone 8705417100
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Pine Bluff, AR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs -0.7 yrs vs City Avg
City Avg: 9.7 Yrs
State Avg: 11.2 Yrs
Regional Practice Density
11 Specialists

Practicing in Pine Bluff, AR (702 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
93.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Russworm (9 Years) 9 Yrs
Pine Bluff Specialty Average (9.7 Years) 9.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99284 Emergency department visit with moderate level of medical decision making
152 146 $1487.00 $93.60
99285 Emergency department visit for life threatening or functioning severity
146 143 $2194.00 $136.92

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License AR A005484

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Ouachita County Medical Center

638 California Ave Sw, Camden, AR 717014604

Phone: 8708361000

Wh Services Arkansas, Llc

1601 New Castle Rd, Forrest City, AR 723352218

Phone: 4693643333

Southeast Arkansas Emergency Physicians Llp

1600 W 40th Ave, Pine Bluff, AR 716036301

Phone: 8705417100

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
NPI 1053725499

Doctor of Medicine (M.D.)

Dr. Naznin Jamal , MD

Internal Medicine

NPI 1083873590

Doctor of Medicine (M.D.)

Shelly Caine , RN

Registered Nurse - Maternal Newborn

NPI 1164044509

Registered Nurse

Ashwini Potharam

Student in an Organized Health Care Education/Training Program

NPI 1184474785
Ashleigh Culclager

Student in an Organized Health Care Education/Training Program

NPI 1205013786
Dr. Kolton Hooks , DNP, CRNA

Nurse Anesthetist, Certified Registered

NPI 1306639083

Doctor of Nursing Practice, Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 25, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 25, 2018

Registered at 1600 W 40TH AVE, PINE BLUFF, AR 716036301 (Tel: 8705417100)

📍
Updated Business Mailing Address January 25, 2018

Registered at 200 CORPORATE BLVD, LAFAYETTE, LA 705083870 (Tel: 8008939698)

👤
Provider Name / Credentials Updated January 25, 2018

Recorded as KEITH RUSSWORM, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2018

Nurse Practitioner (License #A005484 in AR)

🟢
Initial NPI Registration & Enumeration January 15, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497263222
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 15, 2018
Last Update: January 25, 2018
Sole Proprietor: No

Mailing Address

200 Corporate Blvd

Lafayette, LA 705083870

Phone: 8008939698

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.