Individual provider Active NPI

Jonathan Wallace Gurr, M.D.

  • Pediatrics Physician
  • Scottsboro, AL
National Provider Identifier
1386971257
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD. 35327 Issued in AL
Practice address
23800 John T. Reid Pkwy
Scottsboro, AL 35769
Phone
(256) 997-5900
Fax
(256) 997-5995
NPI assigned
Nov 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD. 35327 AL Primary
Pediatrics Physician 208000000X 76726 GA

Addresses

Primary practice location

23800 John T. Reid Pkwy
Scottsboro, AL 35769

Mailing address

1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347
Phone (256) 997-5900

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206001481 AL Practitioner - General Practice 7911433479 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD. 35327ALMDPediatrics Physician
76726GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Aug 22, 2024 Accepting new patients
Fort Payne Pediatrics LLC Pediatrics Past Accepting new patients
Kids 1St Pediatrics, LLC Pediatrics PastSince May 10, 2020 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1386971257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 OLD WATER WORKS RD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683347",
            "telephone_number": "256-997-5900",
            "fax_number": "256-997-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 JOHN T. REID PKWY",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "35769",
            "telephone_number": "256-997-5900",
            "fax_number": "256-997-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURR",
        "first_name": "JONATHAN",
        "middle_name": "WALLACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD. 35327",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "76726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.