Individual provider Active NPI

Michael Wells, D.C., L.AC

  • Chiropractor
  • Encino, CA
National Provider Identifier
1801121678
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31411 Issued in CA
Practice address
5363 Balboa Blvd Ste 234
Encino, CA 91316-2825
Phone
(818) 788-4220
Fax
(818) 789-6077
NPI assigned
Oct 12, 2009
Last updated
Nov 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-31411 CA Primary
Acupuncturist 171100000X AC16721 CA

Addresses

Primary practice location

5363 Balboa Blvd Ste 234
Encino, CA 91316-2825

Mailing address

5363 Balboa Blvd Ste 234
Encino, CA 91316-2825
Phone (818) 788-4220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000843 CA Practitioner - Chiropractic 0042349235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5363 Balboa Blvd
Suite 234
Encino, CA 91316-2825
Phone (818) 788-4220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-31411CAMDChiropractor
31411CAMDGeneral Practice Dentistry
AC16721CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Wells Chiropractic Corporation Chiropractor CurrentSince Feb 1, 2010 Accepting new patients

Locations

5363 Balboa Blvd
Ste 234
Encino, CA 91316
Phone (818) 788-4220

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": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1801121678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 234",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162825",
            "telephone_number": "818-788-4220",
            "fax_number": "818-789-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 234",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162825",
            "telephone_number": "818-788-4220",
            "fax_number": "818-789-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-12",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31411",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC16721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.