Active NPI
Jessica Nichole Wells, DPT
- Physical Therapist
- Fort Worth, TX
National Provider Identifier
1053694752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1206901
- Practice address
- 1000 Saint Louis Ave
Suite 102
Fort Worth, TX 76104-3366 - Phone
- (817) 921-5020
- Fax
- (817) 921-5022
- NPI assigned
- Sep 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 1206901 | TX | Primary |
Addresses
Primary practice location
1000 Saint Louis Ave
Suite 102
Fort Worth, TX 76104-3366
Mailing address
305 NE Loop 280; Business Tower 1
Suite 200
Hurst, TX 76053
Phone (817) 292-8787
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1206901 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1053694752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 280; BUSINESS TOWER 1",
"address_2": "SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "76053",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 SAINT LOUIS AVE",
"address_2": "SUITE 102",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761043366",
"telephone_number": "817-921-5020",
"fax_number": "817-921-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "JESSICA",
"middle_name": "NICHOLE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-20",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1206901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.