Active NPI
Kum Im Wells
- Registered Dietitian
- Lompoc, CA
National Provider Identifier
1124246798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 589955
- Practice address
- 301 N R St
Lompoc, CA 93436-5226 - Phone
- (805) 737-6473
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 589955 | CA | Primary |
Addresses
Primary practice location
301 N R St
Lompoc, CA 93436-5226
Mailing address
300 N San Antonio Rd
Santa Barbara, CA 93110-1316
Phone (805) 681-5461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 589955 | Other | CA | RD REGISTRATION # |
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 |
|---|---|---|---|
| 589955 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124246798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N SAN ANTONIO RD",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931101316",
"telephone_number": "805-681-5461",
"fax_number": "805-681-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N R ST",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934365226",
"telephone_number": "805-737-6473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "KUM IM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "589955",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RD REGISTRATION #",
"identifier": "589955",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.