Individual provider Active NPI

Kelly Nicole Wells, FNP-C

  • Family Nurse Practitioner
  • Danville, VA
National Provider Identifier
1336854942
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024186235 Issued in VA
Practice address
705 Main St
Danville, VA 24541-1803
Phone
(434) 791-4123
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024186235 VA Primary

Addresses

Primary practice location

705 Main St
Danville, VA 24541-1803

Mailing address

705 Main St
Danville, VA 24541-1803
Phone (434) 791-4123

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Beginning Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307001349 VA Practitioner - Nurse Practitioner 0042683385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 Main St
Danville, VA 24541-1803
Phone (434) 791-4122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Access to Health Services, Inc CurrentSince Mar 1, 2023 Accepting new patients
Piedmont Access to Health Services, Inc Current Accepting new patients
Piedmont Access to Health Services, Inc CurrentSince Mar 1, 2023 Accepting new patients
Piedmont Access to Health Services Inc Past Accepting new patients

Locations

30 S Main St
Chatham, VA 24531
Phone (434) 432-4443

705 Main St
Danville, VA 24541
Phone (434) 791-4122

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1336854942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411803",
            "telephone_number": "434-791-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411803",
            "telephone_number": "434-791-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024186235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Beginning",
            "affiliation": "N",
            "endpointDescription": "End",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "705 Main St",
            "city": "Danville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245411803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.