Gwendellyn L McLean, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

00004159 Issued in AL

Practice address

2022 Brookwood Medical Center Dr
Suite 409 Acc
Birmingham, AL 35209

Phone

(205) 879-9290

Fax

(205) 879-5456

NPI assigned

Feb 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gwendellyn L McLean MD PA

  • Dermatology Physician
  • Birmingham, AL
  • NPI 1881743128
  NPD (past) Authorized official

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194799429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 BROOKWOOD MEDICAL CENTER DR",
            "address_2": "SUITE 409 ACC",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-879-9290",
            "fax_number": "205-879-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 BROOKWOOD MEDICAL CENTER DR",
            "address_2": "SUITE 409 ACC",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-879-9290",
            "fax_number": "205-879-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "GWENDELLYN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "00004159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "0310031",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew McLarty, PT, DPT
• Brent A McLarty, M.D.
• Maxwell Ryan McLaughlin, PA
• Carrie McLaulin, M.D.
• Tiffany W McLaurin
• Kay McLean
• Mamie Robinson McLean
• Owen Russell McLean, MD
• Heather Nicole McLellan, MSW
• Amy Shelton McLemore, RPH

• Dermatology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.