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MCREYNOLDS WELLNESS CLINIC PLLC NPI 1861862914


NPI Information

NPI: 1861862914
Provider Name: MCREYNOLDS WELLNESS CLINIC PLLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 04D2121554

Address:
5300 S SOUTHERN HILLS CT STE 100
ROGERS, AR
ZIP 72758
Phone: (479) 636-1324
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MCREYNOLDS WELLNESS CLINIC PLLC is a clinic center in Rogers, AR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MCREYNOLDS WELLNESS CLINIC PLLC NPI is 1861862914. The provider is registered as an organization entity type.

The provider's business location address is:

5300 S SOUTHERN HILLS CT STE 100
ROGERS, AR
ZIP 72758-500
Phone: (479) 636-1324
Fax: (479) 372-4433

The provider's authorized official is Sarah Jane Mcreynolds Brinkley .
The authorized official title is Aprn/owner and has the following contact phone number (479) 224-6368.

The CLIA number assigned to this NPI record is 04D2121554 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2015 and was last updated on 3/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterS02246ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1S02246OTHERARKANSASAPRN LICENSE
21366776429OTHERNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.