Individual provider Active NPI

Bruce H Wellmon, DPM

  • Podiatrist
  • Gaffney, SC
National Provider Identifier
1437346475
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
86 Issued in SC
Practice address
101 Professional Park
Gaffney, SC 29340-2319
Phone
(864) 487-5516
Fax
(864) 487-3477
NPI assigned
Oct 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 86 SC Primary

Addresses

Primary practice location

101 Professional Park
Gaffney, SC 29340-2319

Mailing address

PO Box 1436
Gaffney, SC 29342-1436
Phone (864) 487-5516

Other identifiers 1

IdentifierTypeStateIssuer
PD0868MedicaidSC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000126 SC Practitioner - Podiatry 0244201895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Professional Park
Suite B
Gaffney, SC 29340-2319
Phone (864) 487-5516

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1735
Removal or shaving of skin growth597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce H Wellmon DPM PA Podiatrist CurrentSince Jan 1, 2002 Accepting new patients
Bruce H Wellmon DPM PA Podiatrist Current Accepting new patients

Locations

101 Professional Park
#B
Gaffney, SC 29340
Phone (864) 487-5516

101 Professional Park
Gaffney, SC 29340
Phone (864) 487-5516

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1437346475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1436",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293421436",
            "telephone_number": "864-487-5516",
            "fax_number": "864-487-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293402319",
            "telephone_number": "864-487-5516",
            "fax_number": "864-487-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMON",
        "first_name": "BRUCE",
        "middle_name": "H",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD0868",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.