NPIMap

Individual provider Active NPI

Gregory Matthew Wells, M.D.

  • Nephrology Physician
  • Dothan, AL
National Provider Identifier
1265494181
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME94925 Issued in FL
Practice address
207 Haven Dr
Dothan, AL 36301-2919
Phone
(334) 793-3319
Fax
(334) 793-2291
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME94925 FL Primary

Addresses

Primary practice location

207 Haven Dr
Dothan, AL 36301-2919

Mailing address

207 Haven Dr
Dothan, AL 36301-2919
Phone (334) 793-3319

Other identifiers 2

IdentifierTypeStateIssuer
051557875OtherALMEDICARE PROVIDER
009938269MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060906000592 AL Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Nephrology 4284638123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan Hypertension Nephrology AssociatesGroup PAC ID 5991746661, 11 clinicians

Practice addresses (Care Compare)

207 Haven Dr
Dothan, AL 36301-2919
Phone (334) 793-3319

Hospital & facility affiliations

  • DaVita Dothan Dialysis Dialysis facility, Dothan, AL, CCN 012506
  • DaVita Home Options of Dothan (PD) Dialysis facility, Dothan, AL, CCN 012673
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055
  • Dale Medical Center Hospital, Ozark, AL, CCN 010021
  • Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049
  • Wiregrass Medical Center Hospital, Geneva, AL, CCN 011309

Merit-based Incentive Payment System (MIPS)

Final score
19.8 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME94925FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Hypertension Nephrology Associates CurrentSince Jul 10, 2006 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1763 E Main St
Dothan, AL 36301
Phone (334) 673-0246

207 Haven Dr
Dothan, AL 36301
Phone (334) 793-1964

Interoperability endpoints

  • Direct secure messaging: gregory.wells@direct.davitaphysiciansolutions.com
  • Direct secure messaging: gwells14486@southeasthealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1265494181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HAVEN DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012919",
            "telephone_number": "334-793-3319",
            "fax_number": "334-793-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HAVEN DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012919",
            "telephone_number": "334-793-3319",
            "fax_number": "334-793-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "GREGORY",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME94925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "051557875",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009938269",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.