Active NPI
Collin Ray Wells
- Specialist
- Detroit, MI
National Provider Identifier
1811708449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1701048852
- Practice address
- 6475 Brace St
Detroit, MI 48228-4732 - Phone
- (313) 781-5350
- NPI assigned
- Jan 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1701048852 | MI | Primary |
Addresses
Primary practice location
6475 Brace St
Detroit, MI 48228-4732
Mailing address
6475 Brace St
Detroit, MI 48228-4732
Phone (313) 781-5350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1701048852 | MI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1811708449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6475 BRACE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482284732",
"telephone_number": "313-781-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6475 BRACE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482284732",
"telephone_number": "313-781-5350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "COLLIN",
"middle_name": "RAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-14",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "1701048852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.