Treva M Churchwell, RN WON

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

License

R85437 Issued in AR

Practice address

1 Medical Park Dr
Benton, AR 72015-3353

Phone

(501) 776-6000

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1891402863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 HORSESHOE LOOP",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722069020",
            "telephone_number": "501-580-1450",
            "fax_number": "501-500-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-776-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Parkstone Cir",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721167086",
            "country_code": "US",
            "telephone_number": "501-748-3333",
            "fax_number": "877-713-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCHWELL",
        "first_name": "TREVA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN WON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R85437",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "AR",
            "license": "R85437",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "AR",
            "license": "R85437",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "AR",
            "license": "R85437",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": "AR",
            "license": "R85437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie M Christian, M.A. CCC-SLP
• Jennifer Chronister, RECOVERY ASSISTANT
• Chris Chumley, SUPPORTIVE EMPLOY SP
• Samuel Chumley
• Sarah Jane Chunn, MS, RD, LD
• Cindy J. Webb, PLLC
• Blakely Cingolani
• Civitan Center
• Courtney A Clark, LPC
• Elizabeth Clark, PT, DPT

• Wound Care Registered Nurse in Benton, AR
• Providers in Benton, AR by specialty
• Wound Care Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.