NPIMap

Individual provider Active NPI

Wayne Dwight Austin, M.D.

  • Internal Medicine Physician
  • Winder, GA
National Provider Identifier
1306959754
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207R00000X Issued in GA
Practice address
260 N Broad St
Winder, GA 30680-2180
Phone
(770) 867-9800
Fax
(770) 868-4569
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207R00000X GA Primary

Addresses

Primary practice location

260 N Broad St
Winder, GA 30680-2180

Mailing address

PO Box 1761
260 North Broad Street
Winder, GA 30680-6761
Phone (770) 867-9800

Other identifiers 2

IdentifierTypeStateIssuer
000228555CMedicaidGA
235579OtherGABLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080731000011 GA Practitioner - Internal MedicinePractitioner - Family Practice 8224102850 Practice locations: Winder, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Medical College of Georgia School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

260 N Broad St
Winder, GA 30680-2180
Phone (770) 867-9800

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Pruitthealth at Home - Atlanta Home health agency, Norcross, GA, CCN 117118
  • St. Mary'S Home Health Care Services Home health agency, Watkinsville, GA, CCN 117019
  • St Mary'S Hospital Hospital, Athens, GA, CCN 110006
  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207R00000XGAMDStudent in an Organized Health Care Education/Training Program

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1306959754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1761",
            "address_2": "260 NORTH BROAD STREET",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306806761",
            "telephone_number": "770-867-9800",
            "fax_number": "770-868-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 N BROAD ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802180",
            "telephone_number": "770-867-9800",
            "fax_number": "770-868-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "WAYNE",
        "middle_name": "DWIGHT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "207R00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000228555C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "235579",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winder, GA

Sources for this page

Verify at the official NPI Registry.