Wanda Faye Mooney, APRN
Individual provider Active NPI Family Nurse Practitioner · Bay, AR
NPI 1316557705 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1316557705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 125714 (AR)
- Practice address
- 201 S Bay Dr
Bay, AR 72411-9482 - Phone
- (870) 770-1920
- Fax
- (870) 994-7488
- NPI assigned
- Jul 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 12
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arkansas Methodist Hospital Corporation
Practice addresses (Care Compare)
1000 W Kingshighway
Paragould, AR 72450-4197
Hospital & facility affiliations
- Arkansas Methodist Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200807001805 | AR | Practitioner - Nurse Practitioner | 5698190684 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125714 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients | |
| St Bernards Physician Clinics Inc | Current | Accepting new patients | |
| Arkansas Methodist Hospital Corporation | Family | Current |
Accepting new patients |
| St Bernards Physician Clinics Inc | Current |
Accepting new patients | |
| St Bernards Physician Clinics Inc | Current |
Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients |
Locations
4901 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 932-8222
800 S Church St
Ste 302
Jonesboro, AR 72401
Phone (501) 935-3990
1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432
1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242
1000 W Kingshighway
Ste 14
Paragould, AR 72450
Phone (870) 239-7103
900 W Kingshighway
Paragould, AR 72450
Phone (870) 239-7000
Interoperability endpoints
- wfmooney@sbpc.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 125714 | AR | Yes |
Addresses
Primary practice location
201 S Bay Dr
Bay, AR 72411-9482
Mailing address
4320 Trailwater Dr
Jonesboro, AR 72404-9194
Other names
- Wanda Faye Ellis
Other providers in Bay, AR
- Bradley Bibb MD PLLC
- Angela Burgess
- Phillip Carmer
- Randi L Davis
- Brittany K Fair
- Crissie Parks
- Jessica Strickland
- Tailgate Time Inc
All providers in Bay, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.