Active NPI
Cydnei Octavia Wells, LAT
- Athletic Trainer
- Itasca, TX
National Provider Identifier
1245903350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT9010
- Practice address
- 123 N College St
Itasca, TX 76055-2307 - Phone
- (254) 687-2922
- NPI assigned
- Jul 26, 2021
- Last updated
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT9010 | TX | Primary |
Addresses
Primary practice location
123 N College St
Itasca, TX 76055-2307
Mailing address
330 Old Brandon Rd
Milford, TX 76670-1182
Phone (903) 922-1362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT9010 | TX | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Itasca Isd | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Local Education Agency (LEA)
- Itasca, TX
- NPI 1356482558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1245903350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 OLD BRANDON RD",
"city": "MILFORD",
"state": "TX",
"postal_code": "766701182",
"telephone_number": "903-922-1362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 N COLLEGE ST",
"city": "ITASCA",
"state": "TX",
"postal_code": "760552307",
"telephone_number": "254-687-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "CYDNEI",
"middle_name": "OCTAVIA",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-26",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT9010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Itasca, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.