Kenneth Wells, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

E3455 Issued in CA

Practice address

286 Euclid Ave
Suite 204
San Diego, CA 92114-3610

Phone

(619) 527-0051

Fax

(619) 527-0056

NPI assigned

Dec 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1467437624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "619-527-0051",
            "fax_number": "619-527-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "619-527-0051",
            "fax_number": "619-527-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KENNETH",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-10",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E3455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E34550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grant Wells
• Heather Wells, BCBA
• Janet Wells, L.AC.
• John Myron Wells, D.C.
• Jovon Wells, IDC
• Leslie Louise Wells, M.D.
• Madison Wells
• Nicole Wells, B.S.
• Raymond J Wells
• Stephanie Marie Wells, RBT

• Primary Podiatric Medicine Podiatrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.