Individual provider Active NPI

Donald E Wleklinski, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Siloam Springs, AR
National Provider Identifier
1891130555
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A003818 Issued in AR
Practice address
920 S Carl St BLDG 2
Siloam Springs, AR 72761-4108
Phone
(479) 238-2552
Fax
(479) 373-6737
NPI assigned
May 7, 2013
Last updated
Apr 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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 Practitioner 363LP0808X A003818 AR Primary

Addresses

Primary practice location

920 S Carl St BLDG 2
Siloam Springs, AR 72761-4108

Mailing address

920 S Carl St BLDG 2
Siloam Springs, AR 72761-4108
Phone (479) 238-2552

Other identifiers 1

IdentifierTypeStateIssuer
199300758MedicaidAR

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
I20131106000826 AR Practitioner - Nurse Practitioner 2466687074 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A003818ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates, L.C. CurrentSince Aug 14, 2013 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Aug 14, 2013 Accepting new patients
Uhs of Springwoods LLC CurrentSince Feb 26, 2015 Accepting new patients
Northwest Benton County Physician Services LLC CurrentSince May 1, 2018 Accepting new patients
Momentum Counseling, PLLC Past Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

1955 W Truckers Dr
Fayetteville, AR 72704
Phone (479) 973-6000

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1891130555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S CARL ST BLDG 2",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614108",
            "telephone_number": "479-238-2552",
            "fax_number": "479-373-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S CARL ST BLDG 2",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614108",
            "telephone_number": "479-238-2552",
            "fax_number": "479-373-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLEKLINSKI",
        "first_name": "DONALD",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A003818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199300758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Siloam Springs, AR

Sources for this page

Verify at the official NPI Registry.