Mark Anthony Wendolowski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41411 Issued in AL

Practice address

294 Summar Dr
Jackson, TN 38301-3915

Phone

(731) 423-1931

NPI assigned

Mar 30, 2019

Last updated

Aug 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AL2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athens-Limestone ER PhysiciansGroup PAC ID 6204084502, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Athens Limestone Hospital Hospital, Athens, AL, CCN 010079
• Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131

Merit-based Incentive Payment System (MIPS)

Final score

41.83 of 100Reported as group

Quality

3.95

Improvement activities

40

Cost

82.18

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athens-Limestone ER Physicians

  • Emergency Medicine Physician
  • Athens, AL
  • NPI 1528314119
  Medicare reassignment Care Compare group NPD
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855
  Medicare reassignment NPD
• Crestwood HB Medical Services LLC

  • Emergency Medicine Physician
  • Huntsville, AL
  • NPI 1548940497
  Medicare reassignment NPD
• HH Crestwood ER Physicians Group

  • Emergency Medicine Physician
  • Huntsville, AL
  • NPI 1811842826
  Medicare reassignment
• Blossomwood Medical PC

  dba Blossomwood Medical

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1144451311
  NPD (past)

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

• Crestwood Healthcare LP

  dba Crestwood Medical Center

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1023061496
  Care Compare affiliation
• HH Health System - Athens Limestone, LLC

  dba Athens Limestone Hospital

  • General Acute Care Hospital
  • Athens, AL
  • NPI 1144695081
  Care Compare affiliation

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1396206371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 COUNT FLEET CT",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564296",
            "telephone_number": "670-790-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "256-539-0505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Vocational Dr SW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301616795",
            "country_code": "US",
            "telephone_number": "678-790-4262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENDOLOWSKI",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-30",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "41411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellness Ambulatory Care Inc. (BHG Medical Services Jackson)
• Wellness Clinic and Family Care PLLC
• Pamela A Wells, M.D.
• Ruth Lyn Wells, PHARM.D.
• Christopher Welsch, M.D.
• Jay M Wentworth, P.T.
• West Tennessee Anesthesia, PC
• West Tennessee Bone and Joint Clinic PC
• West Tennessee Center for Oral and Facial Surgery
• West Tennessee Cerebral Palsy Association

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.