Serenity Gynecology, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

SERENITY GYNECOLOGY, LLC

Practice address

300 Glynn Street South
Fayetteville, GA 30214

Phone

(770) 629-2702

Fax

(770) 909-5004

NPI assigned

Mar 3, 2020

Organization subpart

No

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

Authorized official

Name

Tracey St. Julian, MDNPI 1306901467

Title

Physician Owner

Phone

(770) 629-2702

Specialties & licenses 1

Addresses

Other names 1

• Premier Women's Gyn, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracey Lynn St. Julian, MD

  • Obstetrics & Gynecology Physician
  • Fayetteville, GA
  • NPI 1306901467
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1295360949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GLYNN STREET SOUTH",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-629-2702",
            "fax_number": "770-909-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GLYNN STREET SOUTH",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-629-2702",
            "fax_number": "770-909-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2024-03-21",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "ST. JULIAN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "770-629-2702",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Women's Gyn, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sydney Sellers
• Senior Personal Care Solutions LLC
• Serene Concepts PC
• Serenity Care Community LLC
• Serenity Counseling & Consulting Services
• Serenity Healthcare Network
• Serenity Safe Care Wellness Family
• Serverus Solutions LLC
• Katina Maree Settle, AGACNP-BC
• Emma Marie Sevriens, RN

• Gynecology Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.