Nicole Marie Wellman, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

U3692 Issued in TX

Practice address

11130 Christus Hills
Medical Plaza 3, 3Rd Floor
San Antonio, TX 78251-3585

Phone

(210) 703-9001

Fax

(210) 703-9155

NPI assigned

May 17, 2021

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

University of the Incarnate Word School of Osteo Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Community Health ClinicGroup PAC ID 7416850318, shared by 4 NPIs, 50 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwellmanmd413847@carlehiedirect.net

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment Care Compare group NPD
• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Methodist Medical Center of Illinois

  dba Methodist Medical Group

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  NPD
• Proctor Health Systems

  dba Carle Health Princeville

  • Rural Health Clinic/Center
  • Princeville, IL
  • NPI 1356057301

  Family Medicine

  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)

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

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1306410105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36168855",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U3692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellfit Personal Training & Post Rehab
• Armistead Landon Wellford, M.D.
• Louanne Wellford, MD
• Evan Welliver
• Kassaundra Wellman
• Wellmed Medical Group, P.a. (Care Coach Connect)
• Wellmed Medical Group, PA
• Wellmed Medical Group, PA (CareCoach Connect)
• Wellmed Networks, Inc. (WellMed Cardiology)
• Wellmed Networks, Inc. (Specialists for Health)

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.