Individual provider Active NPI

Brock Wells, DC

  • Chiropractor
  • Hutchinson, KS
National Provider Identifier
1225416324
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0105706 Issued in KS
Practice address
1435 E 30TH Ave Ste B
Hutchinson, KS 67502-1235
Phone
(620) 860-2174
Fax
(620) 921-3209
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 01-05706 KS
Chiropractor 111N00000X 0105706 KS Primary

Addresses

Primary practice location

1435 E 30TH Ave Ste B
Hutchinson, KS 67502-1235

Mailing address

1435 E 30TH Ave Ste B
Hutchinson, KS 67502-1235
Phone (620) 860-2174

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006692 KS Practitioner - Chiropractic 7214241223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1435 E 30TH Ave
Suite B
Hutchinson, KS 67502-1203
Phone (620) 860-2174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0105706KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Salt City Chiropractic, LLC Chiropractor CurrentSince Jun 2, 2015 Accepting new patients

Locations

1703 Landon St
#A
Hutchinson, KS 67502
Phone (620) 860-2174

1435 E 30th Ave
Ste B
Hutchinson, KS 67502
Phone (620) 860-2174

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Prairiestar Health Center IncHutchinson, KS, CCN 171824 Federally qualified health center Corporate Director Jul 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1225416324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E 30TH AVE STE B",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021235",
            "telephone_number": "620-860-2174",
            "fax_number": "620-921-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 E 30TH AVE STE B",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021235",
            "telephone_number": "620-860-2174",
            "fax_number": "620-921-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05706",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "0105706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

Verify at the official NPI Registry.