Active NPI
Jan Ellen Wells, ARNP
- Family Nurse Practitioner
- Pryor, OK
National Provider Identifier
1942286133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R0027163
- Practice address
- 109 N Fairland St
Suite 104
Pryor, OK 74361-4203 - Phone
- (918) 824-4424
- Fax
- (918) 824-4474
- NPI assigned
- Dec 19, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R0027163 | OK | Primary |
Addresses
Primary practice location
109 N Fairland St
Suite 104
Pryor, OK 74361-4203
Mailing address
109 N Fairland St
Suite 104
Pryor, OK 74361-4203
Phone (918) 824-4424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100094230 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 811 | OK | MD | Speech-Language Pathologist |
| R0027163 | OK | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306800000000",
"number": "1942286133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N FAIRLAND ST",
"address_2": "SUITE 104",
"city": "PRYOR",
"state": "OK",
"postal_code": "743614203",
"telephone_number": "918-824-4424",
"fax_number": "918-824-4474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N FAIRLAND ST",
"address_2": "SUITE 104",
"city": "PRYOR",
"state": "OK",
"postal_code": "743614203",
"telephone_number": "918-824-4424",
"fax_number": "918-824-4474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "JAN",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-19",
"last_updated": "2011-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0027163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100094230",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.