360 Wellness Clinic LLC
NPI 1366048803 · Clinic/Center · Benton, AR
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
360 Wellness Clinic LLC is a Clinic/Center organization in Benton, AR (NPI 1366048803).
Provider details
- NPI number
- 1366048803
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Blake Torres, Owner(501) 778-3151
Specialties & taxonomies
Ambulatory Health Care Facilities
- Rural Health Clinic/Center261QR1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- The Shot Clinic
- Doing business as
- West Side Wellness
- Doing business as
- West Side Wellness
Registry dates
- Enumerated
- 2020-12-09
- Last updated
- 2022-05-09
- Certified
- 2022-05-09
Frequently asked questions
- What is 360 Wellness Clinic LLC's NPI number?
- 360 Wellness Clinic LLC's National Provider Identifier (NPI) is 1366048803, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 360 Wellness Clinic LLC?
- 360 Wellness Clinic LLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is 360 Wellness Clinic LLC located?
- 360 Wellness Clinic LLC's practice location on file with NPPES is 620 W South St Ste a, Benton, AR 72015-4235.
- What is 360 Wellness Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for 360 Wellness Clinic LLC is (501) 794-6123.
- Does 360 Wellness Clinic LLC accept Medicare?
- 360 Wellness Clinic LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for 360 Wellness Clinic LLC?
- The authorized official listed on 360 Wellness Clinic LLC's NPPES record is Blake Torres, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 360 Wellness Clinic LLC's NPI active?
- Yes — 360 Wellness Clinic LLC's NPI (1366048803) is active in the NPPES registry as of the last update on 2022-05-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.