Individual provider Active NPI

Dakota Cheyenne Hilliard

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1639661051
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
122716 Issued in AR
Practice address
533 W Washington Ave
Jonesboro, AR 72401-2782
Phone
(870) 229-0302
Fax
(870) 520-6482
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 122716 AR Primary

Addresses

Primary practice location

533 W Washington Ave
Jonesboro, AR 72401-2782

Mailing address

533 W Washington Ave
Jonesboro, AR 72401-2782
Phone (870) 229-0302

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
I20260422001288 AR Practitioner - Nurse Practitioner 7517441165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Foundation a Wellness Practice, LLCGroup PAC ID 2668718172, 6 clinicians

Practice addresses (Care Compare)

533 W Washington Ave
Jonesboro, AR 72401-2782
Phone (870) 229-0302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122716ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation: a Wellness Practice, LLC Single Specialty CurrentSince Sep 8, 2025 Accepting new patients

Locations

533 W Washington Ave
Jonesboro, AR 72401
Phone (870) 229-0302

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1639661051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012782",
            "telephone_number": "870-229-0302",
            "fax_number": "870-520-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012782",
            "telephone_number": "870-229-0302",
            "fax_number": "870-520-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "DAKOTA",
        "middle_name": "CHEYENNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "122716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.