Christy Michelle Clark-Wells, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2616 Issued in AR

Practice address

219 W Main St
Paragould, AR 72450-4327

Phone

(870) 236-7713

Fax

(870) 236-7714

NPI assigned

Aug 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wells Family Eyecare PA

  • Optometrist
  • Manila, AR
  • NPI 1902279409
  Medicare reassignment NPD Authorized official
• Wells Vision Care, P.a.

  • Optometrist
  • Paragould, AR
  • NPI 1427481589
  Medicare reassignment NPD

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1396901674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 W MAIN ST",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504327",
            "telephone_number": "870-236-7713",
            "fax_number": "870-236-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W MAIN ST",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504327",
            "telephone_number": "870-236-7713",
            "fax_number": "870-236-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-WELLS",
        "first_name": "CHRISTY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2616",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2008022656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Margaret Church, QBHP
• Shaynna Leigh-Ann Churchwell
• City Drug Co
• City Drug Co, Inc.
• City Drug Co, Inc.
• Casandra Clark
• Emili Clark
• Kinsey Clark
• Lindsey Lashae Clark, APRN
• Mindy Lee Clark, PTA

• Optometrist in Paragould, AR
• Providers in Paragould, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.