Keith Aniel Russworm Jr., NP
Keith Aniel Russworm Jr. is a Nurse Practitioner provider (Nurse Practitioner) practicing in Pine Bluff, AR, registered in the NPPES registry with NPI 1497263222 since 2018. The credential NP stands for Nurse Practitioner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1497263222 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Keith Aniel Russworm Jr. |
| Credential | NP |
| Sex | Male |
| Practice address | 1600 W 40TH AVE, Pine Bluff, AR, 71603 |
| Phone | 8705417100 |
| Enumeration date | 2018-01-15 |
| Last updated in NPPES | 2018-01-25 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | Primary | A005484 | AR |
NP — Nurse Practitioner: An advanced practice registered nurse with graduate training, licensed to diagnose and treat, often with prescriptive authority. About the NP credential
Copy-ready billing details
Provider: Keith Russworm, NP NPI: 1497263222 Taxonomy: 363L00000X (Nurse Practitioner) Address: 1600 W 40TH AVE, Pine Bluff, AR, 71603
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1033172317 | Rebekah Crowder | Individual | Registered Dietitian | Pine Bluff, AR |
| 1376590083 | South Arkansas Pathology, Pllc | Organization | Anatomic Pathology & Clinical Pathology Physician | Pine Bluff, AR |
| 1487601712 | Nauman Yunus | Individual | Internal Medicine Physician | Pine Bluff, AR |
| 1235179581 | Jefferson Hospital Association, Inc. | Organization | Internal Medicine Physician | Pine Bluff, AR |
| 1366483992 | Pine Bluff Pathologists Pllc | Organization | Anatomic Pathology & Clinical Pathology Physician | Pine Bluff, AR |
| 1790727287 | Rebecca Wheeler | Individual | Anatomic Pathology & Clinical Pathology Physician | Pine Bluff, AR |
| 1376577619 | Aaron Kuperman | Individual | Internal Medicine Physician | Pine Bluff, AR |
| 1962515668 | David Carrouth | Individual | Internal Medicine Physician | Pine Bluff, AR |
Verify this record
Cross-check NPI 1497263222 against the authoritative CMS record: view Keith Aniel Russworm Jr. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2018-01-25.