Your Doctor'S Office, PC
Organization Active NPI Family Medicine Physician · Montgomery, AL
NPI 1003267899 · NPPES record last updated Oct 31, 2016
Key facts
- NPI
- 1003267899
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 24787 (AL)
- Legal business name
- YOUR DOCTOR'S OFFICE, PC
- Practice address
- 8630 Vaughn Rd
Montgomery, AL 36117-8852 - Phone
- (334) 676-4076
- Fax
- (334) 676-4064
- NPI assigned
- Jun 23, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Shaikh Wahiduzzaman, M.D.
- Title
- Manager/Owner
- Phone
- (334) 676-4076
Practitioners 8
-
Leigh Anne Luna, N.P.
-
Mary Traudt-Bowdoin, CRNP
-
Jerrie Denise Baldwin, CRNP
-
Jenny Marie Browning, CRNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2119872 | Your Doctor'S Office | Certificate of waiver | Oct 22, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161031000806 | AL | Part B Supplier - Clinic/Group Practice | 3678851409 |
Receives reassigned benefits from 6 practitioners Practice locations: Montgomery, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 24787 | AL | Yes |
Addresses
Primary practice location
8630 Vaughn Rd
Montgomery, AL 36117-8852
Mailing address
8630 Vaughn Rd
Montgomery, AL 36117-8852
Phone (334) 676-4076
NPI Registry JSON
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1477872000000",
"number": "1003267899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8630 VAUGHN RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361178852",
"telephone_number": "334-676-4076",
"fax_number": "334-676-4064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8630 VAUGHN RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361178852",
"telephone_number": "334-676-4076",
"fax_number": "334-676-4064"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUR DOCTOR'S OFFICE, PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-23",
"last_updated": "2016-10-31",
"status": "A",
"authorized_official_last_name": "WAHIDUZZAMAN",
"authorized_official_first_name": "SHAIKH",
"authorized_official_title_or_position": "MANAGER/OWNER",
"authorized_official_telephone_number": "334-676-4076",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "AL",
"license": "24787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
- Helena Robinson Young
- Jamelle Young
- Jennie R Young
- Laura B Young
- Heather C Youngblood
- Yumeka Yvonne Yowe McKinney
- Kiyana Zachery
- Zack D Studstill LLC
- Mahmood A Zaied
- Areeba Zain
All providers in Montgomery, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.