Individual provider Active NPI

George H. Wakefield III, M.D.

  • Diagnostic Radiology Physician
  • Montgomery, AL
National Provider Identifier
1063497337
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
00013733 Issued in AL
Practice address
1825 Park PL
Montgomery, AL 36106-1149
Phone
(334) 293-8747
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 00013733 AL Primary

Addresses

Primary practice location

1825 Park PL
Montgomery, AL 36106-1149

Mailing address

1825 Park PL
Montgomery, AL 36106-1149
Phone (334) 293-8747

Other identifiers 1

IdentifierTypeStateIssuer
009926595MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001450 AL Practitioner - Diagnostic Radiology 0244138469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Alabama College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Group, P.a.Group PAC ID 3274431481, 10 clinicians

Practice addresses (Care Compare)

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 834-3671

Hospital & facility affiliations

  • Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13733ALMDPharmacist
00013733ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Group, P.a. Diagnostic Radiology CurrentSince Jul 1, 2007 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients

Locations

29 L V Stabler Dr
Greenville, AL 36037
Phone (334) 382-2676

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1722 Pine St
Ste 203
Montgomery, AL 36106
Phone (334) 271-1263

2257 Taylor Rd
Ste 200
Montgomery, AL 36117
Phone (334) 270-9914

1825 Park Pl
Montgomery, AL 36106
Phone (334) 293-8747

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

500 Hospital Dr
Wetumpka, AL 36092
Phone (334) 283-2542

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1063497337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 PARK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061149",
            "telephone_number": "334-293-8747",
            "fax_number": "334-834-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 PARK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061149",
            "telephone_number": "334-293-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "GEORGE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "00013733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009926595",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.