Peggy J Wells, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

07070 Issued in MS

Practice address

2245 N State St
Clarksdale, MS 38614

Phone

(662) 627-4131

Fax

(662) 627-2702

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nwmpwells@yourcarecommunity.org

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.

• Aaron E. Henry Community Health Services Center, Inc

  • Pediatrics Physician
  • Clarksdale, MS
  • NPI 1134868672
  NPD (past)
• Childrens Clinic of Clarksdale PA

  • Pediatrics Physician
  • Clarksdale, MS
  • NPI 1497834030
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710001482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "38614",
            "telephone_number": "662-627-4131",
            "fax_number": "662-627-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N STATE ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "38614",
            "telephone_number": "662-627-4131",
            "fax_number": "662-627-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "PEGGY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "07070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114187",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113143001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Bobo Watson, M.ED, M.A.
• Shastan C Watson, MS
• Skyla Keyuara Brensha Watson, BSW, PCCSS
• Grady Devar Watt, DDS
• Thomas E Weldon, M.D.
• West Clinic, PC
• Westgate Drugs Inc
• Teresa Victoria White Powell, MSN, FNP-C
• Patricia White, FNP
• Andrea L Williams, MSW

• Pediatrics Physician in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.