Individual provider Active NPI

Jed M Wells, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Laredo, TX
National Provider Identifier
1083612238
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
TX1355 Issued in TX
Practice address
6828 Springfield Ave
Suite 2
Laredo, TX 78041-2286
Phone
(956) 726-9797
Fax
(956) 726-9965
NPI assigned
Jul 12, 2005
Reactivated
Mar 28, 2006
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X TX1355 TX Primary

Addresses

Primary practice location

6828 Springfield Ave
Suite 2
Laredo, TX 78041-2286

Mailing address

PO Box 60998
Corpus Christi, TX 78466-0998
Phone (361) 452-4978

Other practice location 1

641 Everhart Rd
Corpus Christi, TX 78411-1903
Phone (361) 452-4978

Other identifiers 1

IdentifierTypeStateIssuer
092738602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000170 TX Practitioner - Podiatry 8224063334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6828 Springfield Ave
Suite 2
Laredo, TX 78041-2287
Phone (956) 726-9797

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX1355TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Laredo's Foot Care Center, PA Foot & Ankle Surgery CurrentSince Sep 9, 2009 Accepting new patients

Locations

641 Everhart Rd
Corpus Christi, TX 78411
Phone (361) 452-4978

6828 Springfield Ave
Ste 2
Laredo, TX 78041
Phone (956) 726-9797

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1083612238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60998",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784660998",
            "telephone_number": "361-452-4978",
            "fax_number": "361-452-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 SPRINGFIELD AVE",
            "address_2": "SUITE 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412286",
            "telephone_number": "956-726-9797",
            "fax_number": "956-726-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 Everhart Rd",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784111903",
            "country_code": "US",
            "telephone_number": "361-452-4978",
            "fax_number": "361-452-5026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JED",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "TX1355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092738602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.