Individual provider Active NPI

Glenn C Wheeling, P..A.

  • Surgery Physician
  • Tuscaloosa, AL
National Provider Identifier
1124171681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
PA-56 Issued in AL
Practice address
1031 Fairfax Park
Tuscaloosa, AL 35406-2807
Phone
(205) 345-2211
Fax
(205) 345-2220
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PA-56 AL Primary

Addresses

Primary practice location

1031 Fairfax Park
Tuscaloosa, AL 35406-2807

Mailing address

1031 Fairfax Park
Tuscaloosa, AL 35406-2807
Phone (205) 345-2211

Other identifiers 1

IdentifierTypeStateIssuer
510-32052OtherBLUE CROSS PROVIDER #

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120321000177 AL Practitioner - Physician Assistant 9133389679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 University Blvd E
Tuscaloosa, AL 35401-2092

809 University Blvd E
Tuscaloosa, AL 35401-2092

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-56ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Alabama Physician Associates, LLC CurrentSince May 1, 2023 Accepting new patients
West Alabama Physician Associates, LLC Past Accepting new patients

Locations

1653 Temple Ave N
Fayette, AL 35555
Phone (205) 759-7063

1031 Fairfax Park
Tuscaloosa, AL 35406
Phone (205) 345-2211

701 University Blvd E
Ste 604
Tuscaloosa, AL 35401
Phone (205) 759-6925

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

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 3

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124171681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062807",
            "telephone_number": "205-345-2211",
            "fax_number": "205-345-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062807",
            "telephone_number": "205-345-2211",
            "fax_number": "205-345-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELING",
        "first_name": "GLENN",
        "middle_name": "C",
        "credential": "P..A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "PA-56",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "510-32052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.