Individual provider Active NPI

James Leroy Wells Jr., MD

  • Cardiovascular Disease Physician
  • Orangeburg, SC
National Provider Identifier
1316012735
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
7836 Issued in SC
Practice address
1595 Carolina Avenue
Orangeburg, SC 29115-4940
Phone
(803) 534-3092
Fax
(803) 531-4698
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 7836 SC Primary

Addresses

Primary practice location

1595 Carolina Avenue
Orangeburg, SC 29115-4940

Mailing address

1595 Carolina Avenue
Orangeburg, SC 29115-4940
Phone (803) 534-3092

Other identifiers 1

IdentifierTypeStateIssuer
078365MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20120123000648 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1951578558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7836SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Jan 20, 1996 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties Cardiovascular Disease Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Jan 20, 1996 Accepting new patients
Cardiovascular Associates, PA Cardiovascular Disease Past Accepting new patients

Locations

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Organizations & group practices 4

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1316012735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 CAROLINA AVENUE",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154940",
            "telephone_number": "803-534-3092",
            "fax_number": "803-531-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 CAROLINA AVENUE",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154940",
            "telephone_number": "803-534-3092",
            "fax_number": "803-531-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JAMES",
        "middle_name": "LEROY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "7836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078365",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.