Organization Active NPI

Time Wellness Arkansas Treatment Resources LLC

  • Clinic/Center
  • Fayetteville, AR
National Provider Identifier
1265287841
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TIME WELLNESS ARKANSAS TREATMENT RESOURCES LLC
Practice address
3911 N Old Missouri Rd Apt 8108
Fayetteville, AR 72703-5722
Phone
(954) 654-2350
NPI assigned
Apr 18, 2024
Last updated
Apr 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Daniel Fesefeldt
Title
Coo
Phone
(954) 654-2350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

3911 N Old Missouri Rd Apt 8108
Fayetteville, AR 72703-5722

Mailing address

1830 Wagon Wheel Rd
Springdale, AR 72762-7914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1265287841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 WAGON WHEEL RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 N OLD MISSOURI RD APT 8108",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035722",
            "telephone_number": "954-654-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIME WELLNESS ARKANSAS TREATMENT RESOURCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "FESEFELDT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-654-2350"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.