Active NPI
New Way Wellness
- Family Medicine Physician
- Bentonville, AR
National Provider Identifier
1063232197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NEW WAY WELLNESS
- Practice address
- 2200 SE J St
Bentonville, AR 72712-4185 - Phone
- (479) 534-9248
- NPI assigned
- Oct 14, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Burks
- Title
- Aprn
- Phone
- (479) 364-0462
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2200 SE J St
Bentonville, AR 72712-4185
Mailing address
2200 SE J St Ste 12
Bentonville, AR 72712-4186
Phone (479) 364-0462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2316225 | New Way Wellness | Certificate of waiver | Dec 30, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Springdale, AR
- NPI 1063102994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787184000000",
"number": "1063232197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 SE J ST STE 12",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124186",
"telephone_number": "479-364-0462",
"fax_number": "479-364-0482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 SE J ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124185",
"telephone_number": "479-534-9248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW WAY WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-14",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A",
"authorized_official_last_name": "BURKS",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "APRN",
"authorized_official_telephone_number": "479-364-0462"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.