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LAKE TOWN WELLNESS LIMITED
NPI 1578375952
Nurse Practitioner - Family in Heber Springs, AR

Active since January 23, 2025CLIA 04D2313983 · Waiver
509 N 2ND ST, HEBER SPRINGS, AR 72543(501) 436-2620(504) 436-2620 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lake Town Wellness Limited NPPES

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

LAKE TOWN WELLNESS LIMITED (NPI 1578375952) is a healthcare organization registered as a family in Heber Springs, Arkansas and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through November 11, 2026 and lists Stephanie Marie Thompson, Owner, as its authorized official.

NPPES Registry Identity

NPI1578375952
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameLAKE TOWN WELLNESS LIMITED
Location Address509 N 2ND STHeber Springs, AR 72543-2513
Mailing Address509 N 2nd StHeber Springs, AR 72543-2513 · (501) 436-2620 · Fax (504) 436-2620
Phone(501) 436-2620
Fax(504) 436-2620
Organization SubpartNo
Authorized OfficialStephanie Marie ThompsonOwner · (501) 250-6688
Enumeration DateJanuary 23, 2025
Last NPPES UpdateMarch 27, 2026
NPPES CertifiedMarch 27, 2026
✔ NPI 1578375952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
509 N 2ND ST, Heber Springs, AR 72543
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake Town Wellness Limited is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lake Town Wellness Limited, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephanie Thompson, APRN
Nurse Practitioner
NPI 1700339256
1031 HIGHWAY 25B
Heber Springs, AR 72543
(501) 436-2620
✔ PECOS✔ Accepts Medicare0.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2313983

Lake Town Wellness, Limited · Heber Springs, AR
Active · expires Nov 11, 2026
CLIA Number04D2313983
Laboratory TypePractitioner Other
Certificate Effective DateNovember 12, 2024
Certificate Expiration DateNovember 11, 2026
Laboratory DirectorStephanie M. Thompson
Laboratory Phone(501) 436-2620
Laboratory LocationLake Town Wellness, Limited509 N 2nd St, Heber Springs, AR 72543
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Lake Town Wellness Limited's NPI number?

The NPI number for Lake Town Wellness Limited is 1578375952. It was assigned to this organization in the NPPES registry on January 23, 2025.

Where is Lake Town Wellness Limited located?

Lake Town Wellness Limited is located at 509 N 2nd St, Heber Springs, AR 72543. The listed phone number is (501) 436-2620.

What is Lake Town Wellness Limited's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lake Town Wellness Limited enrolled in Medicare?

Yes. Lake Town Wellness Limited is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Town Wellness Limited?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Lake Town Wellness Limited. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lake Town Wellness Limited hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2313983) is associated with this NPI, valid through November 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lake Town Wellness Limited was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.