Individual provider Active NPI

Mary Dunlap Wells, MD

  • Obstetrics & Gynecology Physician
  • Fairhope, AL
National Provider Identifier
1487612966
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
00026769 Issued in AL
Practice address
150 South Ingleside
Ste 6
Fairhope, AL 36532
Phone
(251) 928-1222
Fax
(251) 928-2398
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 00026769 AL Primary

Addresses

Primary practice location

150 South Ingleside
Ste 6
Fairhope, AL 36532

Mailing address

150 South Ingleside
Suite 6
Fairhope, AL 36532
Phone (251) 928-1222

Other identifiers 1

IdentifierTypeStateIssuer
009932901MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000723 AL Practitioner - Obstetrics/Gynecology 6709815897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Park OBGYN PCGroup PAC ID 5890609499, 6 clinicians

Practice addresses (Care Compare)

150 S Ingleside St
Suite 6
Fairhope, AL 36532-1804
Phone (251) 928-1222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00026769ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Park OBGYN PC Obstetrics & Gynecology CurrentSince Aug 1, 2005 Accepting new patients
Fairhope Internal Medicine PC PastSince Mar 19, 2018 Accepting new patients

Locations

150 S Ingleside St
#6
Fairhope, AL 36532
Phone (251) 928-1222

19450 Greeno Rd
Fairhope, AL 36532
Phone (251) 928-1222

Interoperability endpoints

  • Direct secure messaging: mary.wells@alc011.digichart.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1487612966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SOUTH INGLESIDE",
            "address_2": "SUITE 6",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-928-1222",
            "fax_number": "251-928-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SOUTH INGLESIDE",
            "address_2": "STE 6",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-928-1222",
            "fax_number": "251-928-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MARY",
        "middle_name": "DUNLAP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "00026769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932901",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.