Individual provider Active NPI

Dina Marie Wells, APRN

  • Family Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1629576152
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005113 Issued in AR
Practice address
3400 SE Macy Rd Ste 18
Bentonville, AR 72712-7844
Phone
(479) 845-0880
Fax
(479) 286-0061
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Medical Clinic Arkansas LLC 143 clinicians

Practice addresses (Care Compare)

451 Phillips St
West Fork, AR 72774-2813
Phone (479) 294-6085

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827000353 AR Practitioner - Nurse Practitioner 5496004350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LLC CurrentSince Sep 3, 2018 Accepting new patients
Access Medical Clinic Arkansas LLC CurrentSince Sep 3, 2018 Accepting new patients
Access Medical Clinic Arkansas LLC Past Accepting new patients
Access Medical Clinic Arkansas LLC Past Accepting new patients
Access Medical Clinic Arkansas LLC Past Accepting new patients

Locations

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

451 Phillips St
West Fork, AR 72774
Phone (479) 294-6085

Interoperability endpoints

  • Direct secure messaging: dina.wells.1@15024.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A005113 AR Primary

Addresses

NPPES NPI Registry

Primary practice location

3400 SE Macy Rd Ste 18
Bentonville, AR 72712-7844

Mailing address

3400 SE Macy Rd Ste 18
Bentonville, AR 72712-7844
Phone (479) 845-0880

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
A005113OtherARCNP
R036076OtherARRN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2018.

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1629576152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SE MACY RD STE 18",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127844",
            "telephone_number": "479-845-0880",
            "fax_number": "479-286-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SE MACY RD STE 18",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127844",
            "telephone_number": "479-845-0880",
            "fax_number": "479-286-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "DINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNP",
            "identifier": "A005113",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "R036076",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.