NPIMap

Individual provider Active NPI

Jeffrey Wells, DO

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1720051972
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036104811 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4038
Phone
(217) 222-6550
NPI assigned
Feb 8, 2006
Last updated
May 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2001010361 MO
Family Medicine Physician 207Q00000X 036104811 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4038

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101108001273 MO Practitioner - Family Practice 1850586595 Reassigns benefits to 1 organization
I20101108001303 IL Practitioner - Family Practice 1850586595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

1410 W Line St
Quincy Medical Group
Palmyra, MO 63461-1831
Phone (573) 769-2213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036104811ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 1, 2016 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 1, 2016 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 1, 2016 Accepting new patients
Marion Co. Nursing Home District Past Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

1102 N County Road 700
Warsaw, IL 62379
Phone (217) 256-3800

1410 W Line St
Palmyra, MO 63461
Phone (573) 485-5166

6996 County Road 326
Palmyra, MO 63461
Phone (573) 769-3710

Interoperability endpoints

  • Direct secure messaging: jwells198402@direct.unitypoint.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1720051972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JEFFREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001010361",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036104811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.