Active NPI
Victoria Wells
- Psychologist
- Syracuse, NY
National Provider Identifier
1356470579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 014176-1
- Practice address
- 800 S Wilbur Ave
Syracuse, NY 13204-2732 - Phone
- (315) 473-6982
- Fax
- (315) 473-4033
- NPI assigned
- Mar 5, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 014176-1 | NY | Primary |
Addresses
Primary practice location
800 S Wilbur Ave
Syracuse, NY 13204-2732
Mailing address
4659 Post Rd
Manlius, NY 13104-2316
Phone (315) 682-7136
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 |
|---|---|---|---|
| 014176-1 | NY | MD | Psychologist |
| 014176 | NY | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York State | Past | Accepting new patients | |
| State of New York Comptrollers Office | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Rome, NY
- NPI 1114101599
-
- Developmental Disabilities Clinic/Center
- Fulton, NY
- NPI 1184758807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356470579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4659 POST RD",
"city": "MANLIUS",
"state": "NY",
"postal_code": "131042316",
"telephone_number": "315-682-7136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S WILBUR AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042732",
"telephone_number": "315-473-6982",
"fax_number": "315-473-4033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "014176-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.