Active NPI
Kyle Eugene Wewers
- Family Nurse Practitioner
- Scranton, AR
National Provider Identifier
1972094175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A005621
- Practice address
- 4280 E State Highway 197
Scranton, AR 72863-9043 - Phone
- (479) 438-2198
- NPI assigned
- May 23, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A005621 | AR | Primary |
Addresses
Primary practice location
4280 E State Highway 197
Scranton, AR 72863-9043
Mailing address
4280 E State Highway 197
Scranton, AR 72863-9043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A005621 | Other | AR | ARKANSAS STATE BOARD OF NURSING |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A005621 | AR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527033600000",
"number": "1972094175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4280 E STATE HIGHWAY 197",
"city": "SCRANTON",
"state": "AR",
"postal_code": "728639043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4280 E STATE HIGHWAY 197",
"city": "SCRANTON",
"state": "AR",
"postal_code": "728639043",
"telephone_number": "479-438-2198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEWERS",
"first_name": "KYLE",
"middle_name": "EUGENE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-23",
"last_updated": "2018-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A005621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS STATE BOARD OF NURSING",
"identifier": "A005621",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scranton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.