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WEST SIDE WELLNESS
NPI 1366048803
Clinic/Center in Benton, AR

Active since December 09, 2020
620 W SOUTH ST STE A, BENTON, AR 72015(501) 794-6123(501) 794-6148 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 9, 2022, Dec 9, 2020 (2 updates tracked since 2020).

About West Side Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WEST SIDE WELLNESS (NPI 1366048803) is a healthcare organization registered as a clinic/center in Benton, Arkansas and active in the NPI registry since December 2020. The organization lists Blake Torres, Owner, as its authorized official.

NPPES Registry Identity

NPI1366048803
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business Name360 WELLNESS CLINIC LLC
Location Address620 W SOUTH ST STE ABenton, AR 72015-4235
Mailing Address620 W South St Ste ABenton, AR 72015-4235 · (501) 794-6123
Phone(501) 794-6123
Fax(501) 794-6148
Organization SubpartNo
Authorized OfficialBlake TorresOwner · (501) 778-3151
Enumeration DateDecember 9, 2020
Last NPPES UpdateMay 9, 20222 updates tracked since enumeration
NPPES CertifiedMay 9, 2022
✔ NPI 1366048803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
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).
Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X
620 W SOUTH ST STE A, Benton, AR 72015
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Other Names 2

Doing Business AsWest Side Wellness
Doing Business AsThe Shot Clinic

Other Identifiers 2

Other1205911849AR · Npi
Medicaid119185001AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 360 Wellness Clinic LLC's NPI number?

The NPI number for 360 Wellness Clinic LLC is 1366048803. It was assigned to this organization in the NPPES registry on December 9, 2020. The provider is doing business as West Side Wellness and The Shot Clinic.

Where is 360 Wellness Clinic LLC located?

360 Wellness Clinic LLC is located at 620 W South St Ste A, Benton, AR 72015. The listed phone number is (501) 794-6123.

What is 360 Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

What insurance does 360 Wellness Clinic LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list 360 Wellness Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 360 Wellness Clinic LLC was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.