Active NPI
Brian I Wells, DC
- Chiropractor
- Ashtabula, OH
National Provider Identifier
1336105915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1012
- Practice address
- 1956 W Prospect Rd
Ashtabula, OH 44004-6424 - Phone
- (440) 992-0160
- Fax
- (440) 998-0121
- NPI assigned
- Apr 24, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1012 | OH | Primary |
Addresses
Primary practice location
1956 W Prospect Rd
Ashtabula, OH 44004-6424
Mailing address
6608 Amelia Ave
Ashtabula, OH 44004
Phone (440) 992-6022
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000481233 | Other | OH | ANTHEM BLUE CROSS/BLUE SH |
| 4334935 | Other | AETNA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1012 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1336105915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6608 AMELIA AVE",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "44004",
"telephone_number": "440-992-6022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1956 W PROSPECT RD",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440046424",
"telephone_number": "440-992-0160",
"fax_number": "440-998-0121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "BRIAN",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-24",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "1012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS/BLUE SH",
"identifier": "000000481233",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4334935",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.