Organization Active NPI

Grand Prairie Wellness Clinic PLLC

  • Family Medicine Physician
  • Stuttgart, AR
National Provider Identifier
1679462337
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRAND PRAIRIE WELLNESS CLINIC PLLC
Doing business as
Grand Prairie Wellness Clinic PLLC
Practice address
310 W 22ND St
Stuttgart, AR 72160-6600
Phone
(501) 837-4337
Fax
(844) 689-3150
NPI assigned
Jun 30, 2025
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Kathryn Morris, APRNNPI 1386964708
Title
Owner
Phone
(501) 837-4337

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

310 W 22ND St
Stuttgart, AR 72160-6600

Mailing address

45 Swan B LN
Stuttgart, AR 72160-5653
Phone (501) 837-4337

Other names 2

  • Grand Prairie Wellness Clinic PLLC Doing business as
  • Grand Prairie Wellness Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251217003319 AR Part B Supplier - Clinic/Group Practice 3779078795 Receives reassigned benefits from 2 practitioners
Practice locations: Stuttgart, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2328089Grand Prairie Wellness Clinic310 W 22ND St, Stuttgart, AR 72160Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1679462337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SWAN B LN",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721605653",
            "telephone_number": "501-837-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W 22ND ST",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721606600",
            "telephone_number": "501-837-4337",
            "fax_number": "844-689-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-837-4337",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Prairie Wellness Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Prairie Wellness Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Prairie Wellness Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stuttgart, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.