Individual provider Active NPI

William G Irwin, MD

  • Dermatology Physician
  • Warner Robins, GA
National Provider Identifier
1316931017
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
012172 Issued in GA
Practice address
212 Hospital Dr
Ste C
Warner Robins, GA 31088-4207
Phone
(478) 922-9281
Fax
(478) 328-0438
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 012172 GA Primary
Procedural Dermatology Physician 207NS0135X 012172 GA
Pediatric Dermatology Physician 207NP0225X 012172 GA
General Practice Physician 208D00000X 012172 GA
Dermatopathology Physician 207ND0900X 012172 GA

Addresses

Primary practice location

212 Hospital Dr
Ste C
Warner Robins, GA 31088-4207

Mailing address

2400 Bellevue Rd
Suite 21-a
Dublin, GA 31021-2885
Phone (478) 275-7202

Other identifiers 3

IdentifierTypeStateIssuer
P00167982OtherGARAILROAD MEDICARE
0007629024MedicaidGA
DC4061OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20041109000990 GA Practitioner - Dermatology 1658334719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

1006 Greenfield Dr
Tifton, GA 31794-3794
Phone (229) 386-9333

1157 Forsyth St
Macon, GA 31201-7452
Phone (478) 745-8581

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions61
Skin biopsy42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012172GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Dermatology & Skin Cancer Center, LLC Dermatology CurrentSince Jan 1, 2005 Accepting new patients
Dermatology & Skin Cancer Center Dermatology Past Accepting new patients
Georgia Dermatology &Skin Cancer Center, PC Dermatology Past Accepting new patients

Locations

408 E 4th Ave
Cordele, GA 31015
Phone (912) 276-1122

1380 Gordon St W
Douglas, GA 31533
Phone (912) 384-3204

2400 Bellevue Rd
Ste 21A
Dublin, GA 31021
Phone (478) 275-7202

1157 Forsyth St
Macon, GA 31201
Phone (478) 745-8581

1006 Greenfield Dr
Tifton, GA 31794
Phone (229) 382-8822

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1316931017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "SUITE 21-A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-275-7202",
            "fax_number": "478-274-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DR",
            "address_2": "STE C",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884207",
            "telephone_number": "478-922-9281",
            "fax_number": "478-328-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "012172",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "GA",
            "license": "012172",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "GA",
            "license": "012172",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "012172",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "GA",
            "license": "012172",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00167982",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007629024",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC4061",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.