Individual provider Active NPI

Beverly A Wells, C.N.P.

  • Primary Care Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1053330605
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP03587 Issued in OH
Practice address
2314 Auburn Ave
Cincinnati, OH 45219-2802
Phone
(513) 721-7635
Fax
(513) 721-2313
NPI assigned
Jul 18, 2006
Last updated
May 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP03587 OH Primary

Addresses

Primary practice location

2314 Auburn Ave
Cincinnati, OH 45219-2802

Mailing address

3600 Delaine Ave
Kettering, OH 45429-2706
Phone (937) 298-1341

Other identifiers 1

IdentifierTypeStateIssuer
2368441MedicaidOH

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)
Not enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP03587OHMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1053330605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 DELAINE AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292706",
            "telephone_number": "937-298-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192802",
            "telephone_number": "513-721-7635",
            "fax_number": "513-721-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "NP03587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2368441",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.