Active NPI
Caroline Elisabeth Wellbery, M.D.
- Family Medicine Physician
- Gaithersburg, MD
National Provider Identifier
1952322448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D0046323
- Practice address
- 803 Russell Ave # 1
Secure Medical Care
Gaithersburg, MD 20879-3584 - Phone
- (301) 869-0700
- Fax
- (301) 947-9513
- NPI assigned
- Jul 21, 2006
- Last updated
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 Medicine Physician | 207Q00000X | D0046323 | MD | Primary |
Addresses
Primary practice location
803 Russell Ave # 1
Secure Medical Care
Gaithersburg, MD 20879-3584
Mailing address
5301 Westbard Cir
#417
Bethesda, MD 20816-1401
Phone (301) 913-9143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D0046323 | Other | MD | PROFESSIONAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0046323 | MD | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1952322448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 WESTBARD CIR",
"address_2": "#417",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208161401",
"telephone_number": "301-913-9143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 RUSSELL AVE # 1",
"address_2": "SECURE MEDICAL CARE",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793584",
"telephone_number": "301-869-0700",
"fax_number": "301-947-9513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLBERY",
"first_name": "CAROLINE",
"middle_name": "ELISABETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0046323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "D0046323",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.