Individual provider Active NPI

John A Wells III, MD

  • Ophthalmology Physician
  • West Columbia, SC
National Provider Identifier
1841289154
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
15565 Issued in SC
Practice address
124 Sunset Court
West Columbia, SC 29169
Phone
(803) 931-0077
Fax
(803) 931-0076
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 15565 SC Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 15565 SC

Addresses

Primary practice location

124 Sunset Court
West Columbia, SC 29169

Mailing address

124 Sunset Court
West Columbia, SC 29169
Phone (803) 931-0077

Other identifiers 1

IdentifierTypeStateIssuer
GP0623MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000606 SC Practitioner - Ophthalmology 5294822797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Emory University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Retina Center LLCGroup PAC ID 4486741980, 13 clinicians

Practice addresses (Care Compare)

124 Sunset CT
West Columbia, SC 29169-2429
Phone (803) 744-0156

Hospital & facility affiliations

  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15565SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Retina Center LLC Ophthalmology CurrentSince Aug 3, 1992 Accepting new patients
Carolina Retina Center P.a. Ophthalmology Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 11, 2016 Accepting new patients
Prisma Health Medical Group-Midlands Ophthalmology CurrentSince Dec 11, 2016 Accepting new patients
University Specialty Clinics - Ophthalmology Ophthalmology Past Accepting new patients

Locations

2750 Laurel St
Ste 101
Columbia, SC 29204

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

9 Richland Medical Park Dr
Ste 340
Columbia, SC 29203
Phone (803) 434-2020

400 N Cashua Dr
Florence, SC 29501
Phone (843) 664-9398

1316 N Lake Dr
Lexington, SC 29072
Phone (803) 358-1191

124 Sunset Ct
West Columbia, SC 29169
Phone (803) 744-0155

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jwells@carolinaretinacenter.intellechartdirect.net
  • Direct secure messaging: john.wells@direct.palmettoretina.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1841289154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SUNSET COURT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-931-0077",
            "fax_number": "803-931-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SUNSET COURT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-931-0077",
            "fax_number": "803-931-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "15565",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "SC",
            "license": "15565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0623",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.