Individual provider Active NPI

Michael G Wells, D.O.

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1033181367
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101616 Issued in MO
Practice address
11605 E 23Rd St S
Independence, MO 64050-4201
Phone
(816) 579-6891
NPI assigned
Feb 2, 2006
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 101616 MO Primary

Addresses

Primary practice location

11605 E 23Rd St S
Independence, MO 64050-4201

Mailing address

11605 E 23Rd St S
Independence, MO 64050-4201
Phone (816) 579-6891

Other identifiers 1

IdentifierTypeStateIssuer
243420445MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000572 MO Practitioner - General PracticePractitioner - Family Practice 8628048626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Professional Services of Kansas PAGroup PAC ID 4688072358, 25 clinicians

Practice addresses (Care Compare)

11605 E 23Rd St S
Independence, MO 64050-4201
Phone (816) 579-6891

Hospital & facility affiliations

  • Gentiva Hospice, Kansas City, MO, CCN 261534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Kansas, P.a. CurrentSince Oct 31, 2022 Accepting new patients
Callaway Emergency Physicians, LLC Past Accepting new patients

Locations

11605 E 23rd St S
Independence, MO 64050
Phone (816) 579-6891

3135 Prospect Ave
Kansas City, MO 64128
Phone (816) 209-1237

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
GentivaKansas City, MO, CCN 261534 Hospice Contracted Managing Employee Jan 24, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1033181367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640504201",
            "telephone_number": "816-579-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640504201",
            "telephone_number": "816-579-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "101616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243420445",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.