MEDICARE: APPELLO HEALTH AND WELLNESS CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1275482218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPELLO HEALTH AND WELLNESS CLINIC, LLC

Provider Business Mailing Address
First Line	:	4682 S 48TH ST UNIT B
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-8807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4682 S 48TH ST UNIT B
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-8807
Country	:	US
Telephone Number	:	501-951-3873
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JASON WAYNE LEE
Credential	:
Telephone Number	:	501-772-7518

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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