Active NPI
Nancy Marie Wells, O.D.
- Optometrist
- San Antonio, TX
National Provider Identifier
1366682882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1502
- Practice address
- 17134 Bulverde Rd Ste 107
San Antonio, TX 78247-2190 - Phone
- (210) 267-2686
- Fax
- (210) 267-2216
- NPI assigned
- Feb 23, 2009
- Last updated
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1502 | TN | Primary |
Addresses
Primary practice location
17134 Bulverde Rd Ste 107
San Antonio, TX 78247-2190
Mailing address
17134 Bulverde Rd Ste 107
San Antonio, TX 78247-2190
Phone (210) 267-2686
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1993
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
17134 Bulverde Rd
Suite 107
San Antonio, TX 78247-2190
Phone (931) 217-9540
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 641 | MT | MD | Physician Assistant |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1366682882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17134 BULVERDE RD STE 107",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782472190",
"telephone_number": "210-267-2686",
"fax_number": "210-267-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17134 BULVERDE RD STE 107",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782472190",
"telephone_number": "210-267-2686",
"fax_number": "210-267-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "NANCY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-23",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "1502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.