Wings of Feathers Medical Clinic – Specialist

Key facts

NPI: 1497942486
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: 044861 (GA)
Legal business name: WINGS OF FEATHERS MEDICAL CLINIC
Practice address: 3226 Hampton Ave
Brunswick, GA 31520-4225
Phone: (912) 267-1922
Fax: (912) 267-1437
NPI assigned: Oct 3, 2007
Organization subpart: No

Authorized official

Name: Dr. Cynthia R Ware, M.D. NPI 1891787636
Title: Physician
Phone: (912) 267-1922

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Cynthia R Ware, MD Internal Medicine Physician · Savannah, GA · NPI 1891787636

NPD (past) Authorized official
Sarah Suzanne Ridgeway, APRN Primary Care Nurse Practitioner · Folkston, GA · NPI 1245249176

NPD (past)

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X SINGLE SPECIALTY GROUP	174400000X	044861	GA	Yes

Addresses

Primary practice location

3226 Hampton Ave
Brunswick, GA 31520-4225

Mailing address

PO Box 2663
Brunswick, GA 31521-2663
Phone (912) 267-1922

Other identifiers

Identifier	Type	State	Issuer
1C GRP 7031	Other	GA	MEDICARE GROUP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 3, 2007.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1497942486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2663",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315212663",
            "telephone_number": "912-267-1922",
            "fax_number": "912-267-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 HAMPTON AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204225",
            "telephone_number": "912-267-1922",
            "fax_number": "912-267-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS OF FEATHERS MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-267-1922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "044861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "1C GRP 7031",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

All providers in Brunswick, GA · Specialist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.