Active NPI
Dina Marie Wells, APRN
- Family Nurse Practitioner
- Bentonville, AR
National Provider Identifier
1629576152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A005113
- 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.
-
- Rural Health Clinic/Center
- Heber Springs, AR
- NPI 1407375595
-
- Rural Health Clinic/Center
- Camden, AR
- NPI 1508563362
-
- Rural Health Clinic/Center
- Cedarville, AR
- NPI 1164913984
-
- Rural Health Clinic/Center
- Viola, AR
- NPI 1346869419
-
- Rural Health Clinic/Center
- Sheridan, AR
- NPI 1508360413
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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Clinic Arkansas LLC | Current | Accepting new patients | |
| Access Medical Clinic Arkansas LLC | Current | 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
- dina.wells.1@15024.direct.athenahealth.com
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A005113 | AR | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| A005113 | Other | AR | CNP |
| R036076 | Other | AR | RN |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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; 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.