Wells Surgical Services, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME104932 Issued in FL

Legal business name

WELLS SURGICAL SERVICES, LLC

Practice address

1201 Monument Rd
Suite 201B
Jacksonville, FL 32225-7411

Phone

(904) 281-5878

Fax

(904) 724-9234

NPI assigned

Feb 18, 2013

Organization subpart

No

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

Authorized official

Name

Carol Patricia Bowen-Wells, M.D.NPI 1174710982

Title

President

Phone

(904) 281-5878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carol Patricia Robertine Bowen-Wells, MD

  • Surgical Oncology Physician
  • Jacksonville, FL
  • NPI 1174710982
  Medicare reassignment Authorized official
• Crystal Ann Wade, MSN, AG-ACNP-BC

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1073173142
  Medicare reassignment NPD
• Merland Anthony Baker, M.S.

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1568804011
  NPD (past)
• Xenia T Blount, ARNP

  • Primary Care Nurse Practitioner
  • Gainesville, FL
  • NPI 1003221672
  NPD (past)
• Jelysa Cain, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1861069866
  NPD (past)
• Rogers Cain, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1073551255
  NPD (past)

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1174863872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MONUMENT RD",
            "address_2": "SUITE 201B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257411",
            "telephone_number": "904-281-5878",
            "fax_number": "904-724-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MONUMENT RD",
            "address_2": "SUITE 201B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257411",
            "telephone_number": "904-281-5878",
            "fax_number": "904-724-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS SURGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "BOWEN-WELLS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-281-5878",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME104932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellness Way Jacksonville LLC
• Wellness Wings Home Health Care LLC
• Wellness1524 LLC
• Wells Eye Care, P.a.
• Wells Oral & Maxillofacial Surgery Association
• Tiarra Wells-Young
• Barbara A. Wells, CRNA
• Chantavia Wells
• Darlyn Wells
• David Scott Wells, M.D.

• Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.