NPIMap

Organization Active NPI

Wolf Wellness Center, PLLC

  • Rehabilitation Clinic/Center
  • Holiday Island, AR
National Provider Identifier
1588037196
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
OTR2800 Issued in AR
Legal business name
WOLF WELLNESS CENTER, PLLC
Practice address
23 Parkcliff Dr
Holiday Island, AR 72631-9230
Phone
(479) 363-6422
Fax
(479) 363-6763
NPI assigned
Nov 4, 2015
Last updated
Apr 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Sheila Renee Wolf, OTR/LNPI 1548347404
Title
Director/ Owner
Phone
(479) 363-6422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X OTR2800 AR Primary

Addresses

Primary practice location

23 Parkcliff Dr
Holiday Island, AR 72631-9230

Mailing address

1 Park Dr
Suite a
Holiday Island, AR 72631-9216
Phone (479) 363-6422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160128000537 AR Part B Supplier - Clinic/Group Practice 5395048136 Receives reassigned benefits from 8 practitioners
Practice locations: Holiday Island, AR

National Provider Directory

National Provider Directory

Locations

1 Park Dr
Ste A
Holiday Island, AR 72631
Phone (479) 363-6422

23 Parkcliff Dr
Holiday Island, AR 72631
Phone (479) 363-6422

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1588037196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK DR",
            "address_2": "SUITE A",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319216",
            "telephone_number": "479-363-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PARKCLIFF DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319230",
            "telephone_number": "479-363-6422",
            "fax_number": "479-363-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR/ OWNER",
        "authorized_official_telephone_number": "479-363-6422",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "AR",
            "license": "OTR2800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday Island, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.