Wayne O Wells, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000019895 Issued in TN

Practice address

1430 W Baddour Pkwy
Suite a
Lebanon, TN 37087-2656

Phone

(615) 443-0730

Fax

(615) 443-0722

NPI assigned

Aug 2, 2005

Last updated

Feb 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, IL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wayne O. Wells, M.D.

  • Family Medicine Physician
  • Lebanon, TN
  • NPI 1861681561
  Authorized official Same address or phone
• Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Alton, IL
  • NPI 1033570262
  NPD
• Centerstone of Illinois, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1053455667
  NPD
• Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Marion, IL
  • NPI 1982269601
  NPD

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1780685743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY",
            "address_2": "SUITE A",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872656",
            "telephone_number": "615-443-0730",
            "fax_number": "615-443-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY",
            "address_2": "SUITE A",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872656",
            "telephone_number": "615-443-0730",
            "fax_number": "615-443-0722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Edwards St",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620023915",
            "country_code": "US",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-7160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 S Bentley St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629591908",
            "country_code": "US",
            "telephone_number": "855-608-3560",
            "fax_number": "618-997-6489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "WAYNE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-02-15",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000019895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045377",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Eddie Waters, PHARMD, BCPS, CGP
• Mary Elizabeth Watts, D.D.S.
• Wayne O. Wells, M.D.
• Brandon Craig Weber, PHARMD
• Wells Ness
• Kelly Wentzel, PA
• Clara Elizabeth West
• Holly J West, L.P.C./MHSP
• Willard Mahlon West, M.D.
• Jack Westcott

• Family Medicine Physician in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.