Wolfpack Hearing Clinic, PLLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

License

A#373 Issued in AR

Legal business name

WOLFPACK HEARING CLINIC, PLLC

Practice address

2630 E Citizens Dr Ste 7
Fayetteville, AR 72703-4797

Phone

(479) 957-9300

NPI assigned

Aug 3, 2016

Last updated

Aug 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dustin Richards, AU.D.NPI 1881030732

Title

Owner, Audiologist

Phone

(479) 957-9300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

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.

• Dustin Matthew Richards, AU.D.

  • Audiologist
  • Fayetteville, AR
  • NPI 1881030732
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1376096644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E CITIZENS DR STE 7",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034797",
            "telephone_number": "479-957-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E CITIZENS DR STE 7",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034797",
            "telephone_number": "479-957-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFPACK HEARING CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER, AUDIOLOGIST",
        "authorized_official_telephone_number": "479-957-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "AR",
            "license": "A#373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Witt
• Ashlee Wofford
• Wendy J Wolber, RD, LD
• Neely A Wolf
• Catarina Wolfe
• Holly Womack-Nelson
• Grant Ellis Womack, PHARMD
• Elizabeth Grace Wombolt
• Kathleen Marie Wong, MD
• Katriel Wong

• Hearing and Speech Clinic/Center in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Hearing and Speech Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.