Active NPI
Tyler Gene Wells, CPO
- Prosthetist
- West Palm Beach, FL
National Provider Identifier
1134865140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- POR346
- Practice address
- 901 45TH Street
Kimmel Building
West Palm Beach, FL 33407 - Phone
- (561) 844-5255
- Fax
- (561) 844-5245
- NPI assigned
- May 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | POR346 | FL | |
| Prosthetist | 224P00000X | POR346 | FL | Primary |
Addresses
Primary practice location
901 45TH Street
Kimmel Building
West Palm Beach, FL 33407
Mailing address
667 Blue Jay Rd
Delray Beach, FL 33444-1821
Phone (919) 741-7383
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 |
|---|---|---|---|
| POR346 | FL | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652227200000",
"number": "1134865140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 BLUE JAY RD",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334441821",
"telephone_number": "919-741-7383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 45TH STREET",
"address_2": "KIMMEL BUILDING",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "33407",
"telephone_number": "561-844-5255",
"fax_number": "561-844-5245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "TYLER",
"middle_name": "GENE",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-11",
"last_updated": "2022-05-11",
"certification_date": "2022-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "FL",
"license": "POR346",
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "FL",
"license": "POR346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.