Individual provider Active NPI

Randall Hal Wells, M.D.

  • Psychiatry Physician
  • Hot Springs, AR
National Provider Identifier
1245290816
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C-5671 Issued in AR
Practice address
105 Reserve St
Hot Springs, AR 71901-4195
Phone
(501) 624-4411
Fax
(501) 624-0019
NPI assigned
Mar 27, 2006
Last updated
Jan 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C-5671 AR Primary

Addresses

Primary practice location

105 Reserve St
Hot Springs, AR 71901-4195

Mailing address

105 Reserve St
Hot Springs, AR 71901-4195
Phone (501) 624-4411

Other identifiers 1

IdentifierTypeStateIssuer
105-207-0011MedicaidAR

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1245290816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RESERVE ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719014195",
            "telephone_number": "501-624-4411",
            "fax_number": "501-624-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RESERVE ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719014195",
            "telephone_number": "501-624-4411",
            "fax_number": "501-624-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "RANDALL",
        "middle_name": "HAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "C-5671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105-207-0011",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.