Individual provider Active NPI

Marcus Wellen, M.D.

  • General Acute Care Hospital
  • Little Rock, AR
National Provider Identifier
1962620740
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
E-6668 Issued in AR
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

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
MD037305DCMDPsychosomatic Medicine Physician
E-6668ARMDGeneral 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.

Verify at the official NPI Registry.