Nicole Rene Welle

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA19790 Issued in FL

Practice address

12276 San Jose Blvd
Jacksonville, FL 32223-8628

Phone

(904) 886-3228

NPI assigned

Mar 15, 2024

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1861251548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 ROYAL LAKE DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810509",
            "telephone_number": "803-431-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238628",
            "telephone_number": "904-886-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLE",
        "first_name": "NICOLE",
        "middle_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA19790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Taryn Wellborn, L.A.T.
• Julie M Weller, APRN
• Wellhealth Inc (Wellhealthrx Pharmacy)
• Elizabeth Partridge Wellings, MD
• Nicholas R Wellington, PA-C
• Dawn C Welliver, CRNA

• Occupational Therapy Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.