Individual provider Active NPI

David Ray Wells, O.D.

  • Optometrist
  • Mount Airy, NC
National Provider Identifier
1881691319
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1517 Issued in NC
Practice address
906 W Pine St
Suite 200
Mount Airy, NC 27030-3599
Phone
(336) 719-2000
Fax
(888) 241-5078
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1517 NC Primary

Addresses

Primary practice location

906 W Pine St
Suite 200
Mount Airy, NC 27030-3599

Mailing address

906 W Pine St
Suite 200
Mount Airy, NC 27030-3599
Phone (336) 719-2000

Other identifiers 1

IdentifierTypeStateIssuer
890902LMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525001150 NC Practitioner - Optometry 1254373665 Practice locations: Mount Airy, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

906 W Pine St
Mount Airy, NC 27030-3672
Phone (336) 719-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1517NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Briana J. Shelton OD PA Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1881691319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W PINE ST",
            "address_2": "SUITE 200",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303599",
            "telephone_number": "336-719-2000",
            "fax_number": "888-241-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W PINE ST",
            "address_2": "SUITE 200",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303599",
            "telephone_number": "336-719-2000",
            "fax_number": "888-241-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890902L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.