Active NPI
Patricia G Wells, PT
- Physical Therapist
- Moultrie, GA
National Provider Identifier
1003088287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT001951
- Practice address
- 1912 S Main St
Moultrie, GA 31768-6524 - Phone
- (229) 985-5684
- Fax
- (229) 985-3641
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT001951 | GA | Primary |
Addresses
Primary practice location
1912 S Main St
Moultrie, GA 31768-6524
Mailing address
144 Medical Center Dr Ste a
Copperhill, TN 37317-5006
Phone (423) 496-4390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 549828101A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT001951 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT Solutions LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1003088287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 MEDICAL CENTER DR STE A",
"city": "COPPERHILL",
"state": "TN",
"postal_code": "373175006",
"telephone_number": "423-496-4390",
"fax_number": "423-496-4392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686524",
"telephone_number": "229-985-5684",
"fax_number": "229-985-3641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "PATRICIA",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT001951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "549828101A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.