Active NPI
Marcus Wellen, M.D.
- General Acute Care Hospital
- Little Rock, AR
National Provider Identifier
1962620740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- E-6668
- Practice address
- 4300 West 7TH St.
Central Arkansas Veterans Healtcare System
Little Rock, AR 72205 - Phone
- (501) 257-6585
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychosomatic Medicine Physician | 2084P0015X | MD037305 | DC | |
| General Acute Care Hospital | 282N00000X | E-6668 | AR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4300 West 7TH St.
Central Arkansas Veterans Healtcare System
Little Rock, AR 72205
Mailing address
126 Fountain Ave
Little Rock, AR 72205-5912
Phone (919) 259-0359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD037305 | DC | MD | Psychosomatic Medicine Physician |
| E-6668 | AR | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341532800000",
"number": "1962620740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 FOUNTAIN AVE",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055912",
"telephone_number": "919-259-0359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 WEST 7TH ST.",
"address_2": "CENTRAL ARKANSAS VETERANS HEALTCARE SYSTEM",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-257-6585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLEN",
"first_name": "MARCUS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2012-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0015X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychosomatic Medicine",
"state": "DC",
"license": "MD037305",
"primary": false
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "AR",
"license": "E-6668",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.