Individual provider Active NPI

Adrienne Wells

  • Anesthesiology Physician
  • Lake Orion, MI
National Provider Identifier
1629173059
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036106754 Issued in IL
Practice address
1375 S Lapeer Rd Ste 109
Lake Orion, MI 48360-1421
Phone
(800) 222-1442
Fax
(248) 477-7749
NPI assigned
Sep 13, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036106754 IL Primary

Addresses

Primary practice location

1375 S Lapeer Rd Ste 109
Lake Orion, MI 48360-1421

Mailing address

31500 Northwestern Hwy Ste 140
Farmington Hills, MI 48334-2568
Phone (800) 222-1442

Other practice location 1

1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833
Phone (800) 222-1442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180207002719 MI Practitioner - Anesthesiology 6709079015 Reassigns benefits to 1 organization
I20221014001976 CA Practitioner - Dentist 6709079015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Midwestern University College of Dental Medicine, Glendale, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axon Anesthesia Consultants PLCGroup PAC ID 7012276819, 11 clinicians

Practice addresses (Care Compare)

1375 S Lapeer Rd
Suite 109
Lake Orion, MI 48360-1421
Phone (734) 212-3097

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Axon Anesthesia Consultants, PLC Anesthesiology CurrentSince Jan 2, 2018 Accepting new patients
United Indian Health Services, Inc. Current Accepting new patients
United Indian Health Services, Inc. CurrentSince Aug 14, 2022 Accepting new patients
United Indian Health Services, Inc. CurrentSince Aug 14, 2022 Accepting new patients

Locations

1600 Weeot Way
Arcata, CA 95521
Phone (707) 825-5000

1375 S Lapeer Rd
Ste 109
Lake Orion, MI 48360
Phone (248) 693-7950

Organizations & group practices 4

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629173059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31500 NORTHWESTERN HWY STE 140",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342568",
            "telephone_number": "800-222-1442",
            "fax_number": "248-477-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 S LAPEER RD STE 109",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601421",
            "telephone_number": "800-222-1442",
            "fax_number": "248-477-7749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1653 W Congress Pkwy",
            "address_2": "735 JELKE ANESTHESIA DEPARTMENT",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123833",
            "country_code": "US",
            "telephone_number": "800-222-1442",
            "fax_number": "312-942-5773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "ADRIENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036106754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

Verify at the official NPI Registry.