Active NPI
William David Wynn, MD
- Emergency Medicine Physician
- Corinth, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- T-4135
- Practice address
- 611 Alcorn Dr
Corinth, MS 38834-9321 - Phone
- (662) 293-1000
- NPI assigned
- Jul 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | T-4135 | MS | Primary |
Addresses
Primary practice location
611 Alcorn Dr
Corinth, MS 38834-9321
Mailing address
3283 Shadowood LN
Corinth, MS 38834-6030
Phone (864) 431-3597
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230809000449 | GA | Practitioner - Emergency Medicine | 3870965544 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of South Carolina School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
699 Broad St
Suite 6000
Augusta, GA 30901-1863
Phone (701) 721-6029
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
- Wellstar MCG Health, Affiliated With Med Col
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-4135 | MS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Emergency Medicine Billing Services, LLC | Emergency Medicine | Current | Accepting new patients |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Emanuel County Hospital Authority | Current | Accepting new patients | |
| Magnolia Regional Health Center | Current | Accepting new patients |
Locations
1120 15th St
Bldg O107
Augusta, GA 30912
1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951
1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725
611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961
Interoperability endpoints
- williamwynn@magnolia.medalliesdirect.net
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Augusta, GA
- NPI 1982089777
Emergency Medicine, GA
-
- General Acute Care Hospital
- Corinth, MS
- NPI 1699756445
-
- Surgery Physician
- Swainsboro, GA
- NPI 1003221243
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1447877873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3283 SHADOWOOD LN",
"city": "CORINTH",
"state": "MS",
"postal_code": "388346030",
"telephone_number": "864-431-3597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 ALCORN DR",
"city": "CORINTH",
"state": "MS",
"postal_code": "388349321",
"telephone_number": "662-293-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNN",
"first_name": "WILLIAM",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MS",
"license": "T-4135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corinth, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.