Wells Family Eyecare PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2616 Issued in AR

Legal business name

WELLS FAMILY EYECARE PA

Practice address

804 Medical Dr
Manila, AR 72442-8305

Phone

(870) 570-0400

Fax

(870) 570-0402

NPI assigned

Nov 5, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Christy Michelle Clark-Wells, O,D,NPI 1396901674

Title

Owner

Phone

(870) 570-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christy Michelle Clark-Wells, OD

  • Optometrist
  • Paragould, AR
  • NPI 1396901674
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1902279409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 MEDICAL DR",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724428305",
            "telephone_number": "870-570-0400",
            "fax_number": "870-570-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 MEDICAL DR",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724428305",
            "telephone_number": "870-570-0400",
            "fax_number": "870-570-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS FAMILY EYECARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "CLARK-WELLS",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-570-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O,D,"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185784722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Wagner
• Tommy W Wagner, MD
• Aubrey Garrett Weaver, DPT
• Barbara A Weaver, LCSW
• Amanda Welch
• Letisha L West
• Ellisjah Whaley
• Alicia Dawn Whitlock, LMSW
• Bruce T Wilson, D.D.S.
• Kristy Lynn Wilson, APN

• Optometrist in Manila, AR
• Providers in Manila, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.