Active NPI
Shevonne Katherine Wells, D.P.M.
- Sports Medicine Podiatrist
- Annapolis, MD
National Provider Identifier
1467733006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine Podiatrist
- License
- SC006318
- Practice address
- 695 Kinkaid Rd
Annapolis, MD 21402-1006 - Phone
- (410) 293-4378
- Fax
- (410) 293-1255
- NPI assigned
- Sep 8, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC006318 | PA | |
| Sports Medicine Podiatrist | 213ES0000X | SC006318 | PA | Primary |
Addresses
Primary practice location
695 Kinkaid Rd
Annapolis, MD 21402-1006
Mailing address
695 Kinkaid Rd
Annapolis, MD 21402-1006
Phone (410) 293-4378
Other practice location 1
9300 DeWitt Loop Fl 3
Fort Belvoir, VA 22060-5285
Phone (571) 231-2224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1467733006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 KINKAID RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214021006",
"telephone_number": "410-293-4378",
"fax_number": "410-293-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 KINKAID RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214021006",
"telephone_number": "410-293-4378",
"fax_number": "410-293-1255"
}
],
"practiceLocations": [
{
"address_1": "9300 DeWitt Loop Fl 3",
"address_purpose": "LOCATION",
"city": "Fort Belvoir",
"state": "VA",
"postal_code": "220605285",
"country_code": "US",
"telephone_number": "571-231-2224",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WELLS",
"first_name": "SHEVONNE",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-08",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "PA",
"license": "SC006318",
"primary": false
},
{
"code": "213ES0000X",
"taxonomy_group": "",
"desc": "Podiatrist, Sports Medicine",
"state": "PA",
"license": "SC006318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.