NPIMap

Organization Active NPI

Integrated Wellness and Mental Health, LLC

Doing business as Iwamh

  • Psychiatric/Mental Health Nurse Practitioner
  • Harrison, AR
National Provider Identifier
1053879775
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
INTEGRATED WELLNESS AND MENTAL HEALTH, LLC
Doing business as
Iwamh
Practice address
303 W Newman Ave
Harrison, AR 72601-5839
Phone
(479) 318-2828
NPI assigned
Mar 12, 2019
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Zachariah Hodgson
Title
Owner/Administrator
Phone
(479) 469-0313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

303 W Newman Ave
Harrison, AR 72601-5839

Mailing address

401 N 8TH St Unit 58
Rogers, AR 72757-7148
Phone (479) 469-0313

Other practice location 1

700 N 40th St Ste B
Springdale, AR 72762-0633
Phone (479) 318-2828

Other practice location 2

4200 Jenny Lind Rd Ste C
Fort Smith, AR 72901-7632
Phone (479) 318-2828

Other identifiers 3

IdentifierTypeStateIssuer
203270758MedicaidAR
333671002MedicaidAR
243164762MedicaidAR

Other names 1

  • IWAMH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190827001198 AR Part B Supplier - Clinic/Group Practice 5698016897 Receives reassigned benefits from 9 practitioners
Practice locations: Harrison, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2265403Integrated Wellness and Mental Health700 N 40TH Street, Suite B, Springdale, AR 72762Certificate of waiverJul 26, 2028

National Provider Directory

National Provider Directory

Locations

401 N 8th St
Unit 58
Rogers, AR 72757
Phone (479) 318-2828

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1053879775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 8TH ST UNIT 58",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727577148",
            "telephone_number": "479-469-0313",
            "fax_number": "497-769-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W NEWMAN AVE",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726015839",
            "telephone_number": "479-318-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 N 40th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727620633",
            "country_code": "US",
            "telephone_number": "479-318-2828",
            "fax_number": "479-318-2683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4200 Jenny Lind Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729017632",
            "country_code": "US",
            "telephone_number": "479-318-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS AND MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "HODGSON",
        "authorized_official_first_name": "ZACHARIAH",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "479-469-0313"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203270758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333671002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243164762",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IWAMH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IWAMH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.