KELLI TICE WELLS (NPI# 1972593820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972593820 |
| Entity Type | Individual |
| Full Name | KELLI TICE WELLS |
| Credential | MD |
| Practice Address |
1295 W Fairfield Dr Pensacola FL 32501-1107 |
| Practice Telephone | 8505956500 |
| Mailing Telephone | 8505956501 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2012-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME82944 | FL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | ME82944 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 262522900 | 05 | |
| AL | BLUE CROSS BLUE SHIELD | 59176263 | 01 |
| AL | 009978895 | 05 | |
| AETNA | 7804499 | 01 | |
| MEDICARE RAILROAD | P00195990 | 01 | |
| FL | BLUE CROSS BLUE SHIELD | 06241 | 01 |
| Street Address |
1295 W FAIRFIELD DR |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32501-1107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706985 | Thaer Ahmad Ibrahim Abul Hadi | Pediatrics | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-09-23 |
| 1922617661 | Marmik Patel | Student in an Organized Health Care Education/Training Program | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-07-29 |
| 1073122347 | Hemanthi Durga Veligaram | Pediatrics | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-07-23 |
| 1710595053 | Pallavi Agarwal | Pediatrics | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-07-22 |
| 1609493501 | Qingqing Wang | Student in an Organized Health Care Education/Training Program | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-06-26 |
| 1194342907 | Aline Andrucioli | Student in an Organized Health Care Education/Training Program | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2020-06-26 |
| 1336607936 | Skye Lillian Owens | Dietitian, Registered | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2019-03-04 |
| 1275099947 | Kara Holton | Dietitian, Registered | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2019-02-18 |
| 1447740519 | Miry Lisbeth Makebish | Student in an Organized Health Care Education/Training Program | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2018-05-15 |
| 1558738930 | Maryann E Westbrook | Nurse Practitioner | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2015-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084976 | Steven Bollen | Pharmacist | 870 E Cervantes, Pensacola, FL 32501 | 2020-08-18 |
| 1013558733 | Erica Watts | Social Worker | 901 North I Street, Pensacola, FL 32501 | 2019-10-03 |
| 1972164598 | Yabin Chen | Student in an Organized Health Care Education/Training Program | Fairfield Pediatrics, 1295 W. Fairfield Drive, Pensacola, FL 32501 | 2019-06-25 |
| 1336700038 | Michael Enriquez | Student in an Organized Health Care Education/Training Program | Fairfield Pediatrics- Community Health Nw Fl, 1295 W Fairfield Drive, Pensacola, FL 32501 | 2019-06-24 |
| 1336631803 | Ana Andreea Curta | Student in an Organized Health Care Education/Training Program | Community Health Northwest Florida, 1295 W. Fairfield Drive, Pensacola, FL 32501 | 2018-05-31 |
| 1700374618 | Telecia Walker | Massage Therapist | 1720 W. Fairfield Dr., Ste 309, Pensacola, FL 32501 | 2018-04-26 |
| 1578085254 | Mary Holland Hegarty | Physical Therapist | 1000 W, Moreno St, Pensacola, FL 32501 | 2017-07-13 |
| 1184162455 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1525 E Nine Mile Road, Pensacola, FL 32501 | 2017-02-07 |
| 1215271564 | Pathways for Change, Inc | Social Worker | 2050 West Blount Street, Pensacola, FL 32501 | 2012-11-26 |
| 1962697342 | Martha M Green | Family Medicine | 1717 N E St Ste 222a, Pensacola, FL 32501 | 2007-09-10 |
| Find all providers in zip 32501 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473588 | Marathon Health LLC | Family Medicine | 2257 N Baylen St, Pensacola, FL 32501-1703 | 2020-09-24 |
| 1063049666 | Beth Sample | Family Medicine | 418 W Brainerd St, Pensacola, FL 32501-3062 | 2020-03-24 |
| 1326688458 | Jeane M Thomas | Family Medicine | 4734 Huron Dr, Pensacola, FL 32507-8737 | 2020-01-07 |
| 1932667391 | Julie Ahrend | Family Medicine | 2603 N 16th Ave, Pensacola, FL 32503-4635 | 2019-03-05 |
| 1942765292 | Access Care Family Medicine | Family Medicine | 6705 Pine Forest Rd Ste 505, Pensacola, FL 32526-6911 | 2019-01-31 |
| 1417441742 | Alisha Watson | Family Medicine | 1549 Airport Blvd Ste 200b, Pensacola, FL 32504-8634 | 2018-06-20 |
| 1477094753 | Emily Ellen Crocetti | Family Medicine | Family Medicine Department 6000 W Us Hwy 98, Pensacola, FL 32512-1200 | 2017-03-20 |
| 1821533001 | William Belk Md LLC | Family Medicine | 3450 Oakmont Dr, Pensacola, FL 32503-6900 | 2016-12-27 |
| 1851756852 | Michelle Lynn Smith | Family Medicine | 3700 Creighton Rd, Suite 4, Pensacola, FL 32504-4680 | 2015-12-18 |
| 1659777985 | Dolores Anne Holtmann | Family Medicine | 9400 University Pkwy Ste 409, Pensacola, FL 32514-5485 | 2014-11-13 |
| Find all providers in PENSACOLA | ||||
Please comment or provide details below to improve the information on KELLI TICE WELLS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.