Individual provider Active NPI

Tracy L. Brown Wells, M.D.

  • Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1295797892
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME61217 Issued in FL
Practice address
3 Shircliff Way Ste 200
Jacksonville, FL 32204-4785
Phone
(904) 384-3699
Fax
(904) 384-8529
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME61217 FL Primary

Addresses

Primary practice location

3 Shircliff Way Ste 200
Jacksonville, FL 32204-4785

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0333

Other identifiers 1

IdentifierTypeStateIssuer
376710800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413000049 FL Practitioner - Obstetrics/Gynecology 3072507029 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC CurrentSince Mar 1, 2019 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

2525 Riverside Ave
Jacksonville, FL 32204
Phone (904) 388-0704

2363 Dunn Ave
Jacksonville, FL 32218
Phone (904) 751-6030

3 Shircliff Way
Ste 200
Jacksonville, FL 32204
Phone (904) 308-6463

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1295797892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0333",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044785",
            "telephone_number": "904-384-3699",
            "fax_number": "904-384-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN WELLS",
        "first_name": "TRACY",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME61217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376710800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.