Individual provider Active NPI

Tobijas Wells, D.C.

  • Chiropractor
  • East Moline, IL
National Provider Identifier
1679810667
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012260 Issued in IL
Practice address
1608 10TH St
East Moline, IL 61244-1405
Phone
(309) 755-0323
Fax
(309) 755-9192
NPI assigned
Jan 10, 2013
Last updated
May 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012260 IL Primary

Addresses

Primary practice location

1608 10TH St
East Moline, IL 61244-1405

Mailing address

1608 10TH St
East Moline, IL 61244-1405
Phone (309) 755-0323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131112001016 IL Practitioner - Chiropractic 6800022369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1608 10TH St
East Moline, IL 61244-1405
Phone (309) 755-0323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012260ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wells Chiropractic Inc Chiropractor CurrentSince May 25, 2016 Accepting new patients

Locations

1608 10th St
East Moline, IL 61244
Phone (309) 755-0323

Organizations & group practices 1

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": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1679810667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 10TH ST",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612441405",
            "telephone_number": "309-755-0323",
            "fax_number": "309-755-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 10TH ST",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612441405",
            "telephone_number": "309-755-0323",
            "fax_number": "309-755-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "TOBIJAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-10",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.