Individual provider Active NPI

Wendy Florick

  • Behavior Analyst
  • Springdale, AR
National Provider Identifier
1235145707
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13750 Issued in AR
Practice address
6836 Isaac'S Orchard Rd
Springdale, AR 72762-7096
Phone
(479) 927-4100
Fax
(479) 927-4101
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1898 AR
Behavior Analyst 103K00000X 1-13-13750 AR Primary

Addresses

Primary practice location

6836 Isaac'S Orchard Rd
Springdale, AR 72762-7096

Mailing address

6836 Isaac'S Orchard Rd
Springdale, AR 72762-7096
Phone (479) 927-4100

Other identifiers 2

IdentifierTypeStateIssuer
146031721MedicaidAR
5W835OtherARBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1898ARMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Support Network, Inc CurrentSince May 31, 2020 Accepting new patients
Arkansas Support Network PastSince Oct 13, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1235145707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6836 ISAAC'S ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627096",
            "telephone_number": "479-927-4100",
            "fax_number": "479-927-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6836 ISAAC'S ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627096",
            "telephone_number": "479-927-4100",
            "fax_number": "479-927-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORICK",
        "first_name": "WENDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "1898",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "1-13-13750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146031721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "5W835",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.