Individual provider Active NPI

Mark Lee Wells, PA

  • Physician Assistant
  • Chickasha, OK
National Provider Identifier
1821060849
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1099 Issued in OK
Practice address
411 W Grand Ave
Chickasha, OK 73018-5862
Phone
(405) 224-0053
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1099 OK Primary

Addresses

Primary practice location

411 W Grand Ave
Chickasha, OK 73018-5862

Mailing address

411 W Grand Ave
Chickasha, OK 73018-5862
Phone (405) 224-0053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000656 OK Practitioner - Physician Assistant 9436183365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Resource Management LLCGroup PAC ID 4082753918, 53 clinicians

Practice addresses (Care Compare)

10701 N Rockwell Ave
Oklahoma City, OK 73162-4537
Phone (405) 470-1500

11601 S Western Ave
Oklahoma City, OK 73170-5823
Phone (405) 691-5208

16205 N Pennsylvania Ave
Edmond, OK 73013-7325
Phone (405) 705-5700

2109 S Santa Fe Ave
Moore, OK 73160-2807
Phone (405) 213-0256

301 S Mustang Rd
Yukon, OK 73099-6704
Phone (405) 324-1911

3617 NW Expressway
Oklahoma City, OK 73112-4405
Phone (405) 835-2771

46 E 15TH St
Edmond, OK 73013-4301
Phone (405) 844-5210

5300 SE 29TH St
Oklahoma City, OK 73115-4702
Phone (405) 835-2770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1099OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Health Allset Urgent Care LLC CurrentSince Jan 6, 2025 Accepting new patients
Supreme Healthcare PLLC PastSince Jan 1, 2021 Accepting new patients
Oca MWC LP Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Retail Clinics, LLC Past Accepting new patients
Tricity Family Physicians, PC Past Accepting new patients
Mercy Health Services Inc. Past Accepting new patients
Primacare LP Past Accepting new patients

Locations

3224 S Broadway
Ste 112
Edmond, OK 73013
Phone (405) 427-4941

Interoperability endpoints

  • Direct secure messaging: mark.wellspac.p8@direct.nextcare.nextgenshare.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1821060849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W GRAND AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730185862",
            "telephone_number": "405-224-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W GRAND AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730185862",
            "telephone_number": "405-224-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MARK",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

Verify at the official NPI Registry.