Roy Wells Jr., PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0550030649 Issued in VT

Practice address

45 Church St
Swanton, VT 05488-1434

Phone

(802) 868-2454

Fax

(802) 868-2461

NPI assigned

Aug 11, 2005

Last updated

Oct 15, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Clearchoicemd Primary Care PLLC

  • Family Medicine Physician
  • Saint Albans, VT
  • NPI 1326582529
  NPD (past)
• Northwestern Medical Center, Inc

  dba Northwestern Family Birth Center

  • Pediatrics Physician
  • Saint Albans, VT
  • NPI 1003574740
  NPD (past)
• The Richford Health Center Inc

  dba NOTCH Primary Care

  • Federally Qualified Health Center (FQHC)
  • Saint Albans, VT
  • NPI 1306592613
  NPD (past)
• The Richford Health Center Inc

  • Family Medicine Physician
  • Alburg, VT
  • NPI 1407843543
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1215939079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054540235",
            "telephone_number": "802-868-2454",
            "fax_number": "802-868-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CHURCH ST",
            "city": "SWANTON",
            "state": "VT",
            "postal_code": "054881434",
            "telephone_number": "802-868-2454",
            "fax_number": "802-868-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "ROY",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "0550030649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002358",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00049928",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Richford Health Center Inc (NOTCH Dental Clinic)
• The Richford Health Center Inc
• The Richford Health Center, Inc. (Swanton Rexall)
• Tiffany Elizabeth Trombley, LCMHC, LMHC
• Kristina Myrtis Unikewicz
• Lawrence Hawfield White, M.ED.,LADC, LCMHC
• Amanda L Wilson, MSW, LICSW
• Robert Zelazo, MD

• Physician Assistant in Swanton, VT
• Providers in Swanton, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.