Individual provider Active NPI

John D Wells, MD

  • Hematology & Oncology Physician
  • Fort Smith, AR
National Provider Identifier
1174532469
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C-4063 Issued in AR
Practice address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone
(479) 452-2077
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X C-4063 AR Primary

Addresses

Primary practice location

7301 Rogers Ave
Fort Smith, AR 72903-4100

Mailing address

PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 452-2077

Other identifiers 2

IdentifierTypeStateIssuer
105686001MedicaidAR
827013096OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100203000947 AR Practitioner - Hematology/Oncology 2466595111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-4063ARMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1174532469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-452-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-452-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AR",
            "license": "C-4063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105686001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "827013096",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.