Individual provider Active NPI

Amber Lushea Wellman, DC

  • Chiropractor
  • Brunswick, GA
National Provider Identifier
1205874062
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7572 Issued in GA
Practice address
124 Chapel Crossing Rd
Brunswick, GA 31525-0529
Phone
(912) 554-2002
Fax
(912) 554-2290
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7572 GA Primary

Addresses

Primary practice location

124 Chapel Crossing Rd
Brunswick, GA 31525-0529

Mailing address

124 Chapel Crossing Rd
Brunswick, GA 31525-0529
Phone (912) 554-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060607000082 GA Practitioner - Chiropractic 7012996580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7572GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellman Family Healthcare Chiropractor CurrentSince Apr 24, 2006 Accepting new patients
Family First Chiropractic Inc Chiropractor PastSince Jul 30, 2012 Accepting new patients
Blue Ridge Health and Spine, PLLC Chiropractor PastSince Sep 3, 2016 Accepting new patients

Locations

124 Chapel Crossing Rd
Brunswick, GA 31525
Phone (912) 554-2002

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1205874062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 CHAPEL CROSSING RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250529",
            "telephone_number": "912-554-2002",
            "fax_number": "912-554-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 CHAPEL CROSSING RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250529",
            "telephone_number": "912-554-2002",
            "fax_number": "912-554-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "AMBER",
        "middle_name": "LUSHEA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "7572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.