Physician Compare National (NPI:1366682882)

HEALTHCARE PROVIDER: NANCY MARIE WELLS O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1366682882
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496747115
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191003001859
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WELLS
	Individual professional last name
Provider First Name	NANCY
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RCP EYECARE, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9234474172
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8222 AGORA PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 116
	Group Practice or individual's line 2 address
City	SELMA
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	781541319
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2106591479
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y