Individual provider Active NPI

Craig Allen Wells, DO

  • Family Medicine Physician
  • Egg Harbor Township, NJ
National Provider Identifier
1063808269
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10551600 Issued in NJ
Practice address
302 Arlington CT
Egg Harbor Township, NJ 08234-6012
Phone
(609) 710-1980
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 25MB10551600 NJ
Family Medicine Physician 207Q00000X 25MB10551600 NJ Primary

Addresses

Primary practice location

302 Arlington CT
Egg Harbor Township, NJ 08234-6012

Mailing address

302 Arlington CT
Egg Harbor Township, NJ 08234-6012
Phone (609) 710-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190805000955 NJ Practitioner - Family Practice 8325375090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1310 Blackwood Clementon Rd
Clementon, NJ 08021-5610
Phone (609) 677-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10551600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Family Medicine CurrentSince Jul 9, 2019 Accepting new patients
Atlanticare Urgent Care Physicians LLC CurrentSince Oct 15, 2019 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jul 9, 2019 Accepting new patients

Locations

2500 English Creek Ave
Ste 909
Egg Harbor Twp, NJ 08234
Phone (609) 407-2380

1310 Blackwood Clementon Rd
Laurel Spgs, NJ 08021
Phone (609) 677-7200

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

255 N Route 73
West Berlin, NJ 08091
Phone (609) 569-7040

Organizations & group practices 3

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1063808269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 ARLINGTON CT",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082346012",
            "telephone_number": "609-710-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 ARLINGTON CT",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082346012",
            "telephone_number": "609-710-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CRAIG",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NJ",
            "license": "25MB10551600",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10551600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.