Physician Compare National (NPI:1730100405)

HEALTHCARE PROVIDER: JAMES ESTILL WELLS MD

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

Individual Professional Information
NPI	1730100405
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426005323
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050404000179
	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	JAMES
	Individual professional first name
Provider Middle Name	ESTILL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	APP OF INDIANA ED, PLLC
	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	2961835400
	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	104
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	303 S MAIN ST
	Group Practice or individual's line 1 address
City	BLUFFTON
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	467142503
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2608243210
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150075
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BLUFFTON REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	151302
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INDIANA UNIVERSITY HEALTH BLACKFORD HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150017
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LUTHERAN HOSPITAL OF INDIANA
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y