NPIMap

Organization Active NPI

Center for Psychiatric Wellness, PLLC.

  • Psychiatry Physician
  • Fort Smith, AR
National Provider Identifier
1457733099
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E-7817 Issued in AR
Legal business name
CENTER FOR PSYCHIATRIC WELLNESS, PLLC.
Practice address
7217 Cameron Park Dr
Fort Smith, AR 72903-6167
Phone
(479) 831-6007
Fax
(479) 782-1242
NPI assigned
Jun 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Caylee Cross
Title
Office Manager
Phone
(479) 831-6007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X E-7817 AR Primary

Addresses

Primary practice location

7217 Cameron Park Dr
Fort Smith, AR 72903-6167

Mailing address

PO Box 11137
Fort Smith, AR 72917-1137

Other practice location 1

4400 Rogers Ave
Ste. B
Fort Smith, AR 72903-3145
Phone (479) 831-6007

Other identifiers 1

IdentifierTypeStateIssuer
210878002MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150810002166 AR Part B Supplier - Clinic/Group Practice 8527373232 Receives reassigned benefits from 12 practitioners
Practice locations: Fort Smith, AR

National Provider Directory

National Provider Directory

Locations

4400 Rogers Ave
Ste B
Fort Smith, AR 72903
Phone (479) 831-6007

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1457733099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11137",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 CAMERON PARK DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036167",
            "telephone_number": "479-831-6007",
            "fax_number": "479-782-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 Rogers Ave",
            "address_2": "Ste. B",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729033145",
            "country_code": "US",
            "telephone_number": "479-831-6007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR PSYCHIATRIC WELLNESS, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CAYLEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-831-6007"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-7817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210878002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.