Individual provider Active NPI

John Myron Wells, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1689715104
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC15705 Issued in CA
Practice address
9550 Black Mountain Rd
Ste E
San Diego, CA 92126-4577
Phone
(858) 549-5800
Fax
(858) 578-0722
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC15705 CA Primary

Addresses

Primary practice location

9550 Black Mountain Rd
Ste E
San Diego, CA 92126-4577

Mailing address

9550 Black Mountain Rd
Ste E
San Diego, CA 92126-4577
Phone (858) 549-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081024000379 CA Practitioner - Chiropractic 9133287840 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9550 Black Mountain Rd
San Diego, CA 92126-4577
Phone (858) 549-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC15705CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1689715104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 BLACK MOUNTAIN RD",
            "address_2": "STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264577",
            "telephone_number": "858-549-5800",
            "fax_number": "858-578-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 BLACK MOUNTAIN RD",
            "address_2": "STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264577",
            "telephone_number": "858-549-5800",
            "fax_number": "858-578-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JOHN",
        "middle_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC15705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.