Organization Active NPI

Winfield OB/GYN

  • Obstetrics & Gynecology Physician
  • Winfield, AL
National Provider Identifier
1790720910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12079 Issued in AL
Legal business name
WINFIELD OB/GYN
Practice address
191 Caraway Dr
Suite A1
Winfield, AL 35594-5067
Phone
(205) 487-1203
Fax
(205) 487-1205
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Demie P Weatherly
Title
Office Manager
Phone
(205) 487-1203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 12079 AL Primary

Addresses

Primary practice location

191 Caraway Dr
Suite A1
Winfield, AL 35594-5067

Mailing address

191 Caraway Dr
Suite A1
Winfield, AL 35594-5067
Phone (205) 487-1203

Other identifiers 1

IdentifierTypeStateIssuer
51520459OtherALBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001411 AL Part B Supplier - Clinic/Group Practice 3971599689 Receives reassigned benefits from 1 practitioner
Practice locations: Winfield, AL

National Provider Directory

National Provider Directory

Locations

191 Carraway Dr
Ste A1
Winfield, AL 35594
Phone (205) 487-1203

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4b5a41d6-4f6b-4c64-a2f5-0ec9374f0afa/

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790720910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CARAWAY DR",
            "address_2": "SUITE A1",
            "city": "WINFIELD",
            "state": "AL",
            "postal_code": "355945067",
            "telephone_number": "205-487-1203",
            "fax_number": "205-487-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CARAWAY DR",
            "address_2": "SUITE A1",
            "city": "WINFIELD",
            "state": "AL",
            "postal_code": "355945067",
            "telephone_number": "205-487-1203",
            "fax_number": "205-487-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINFIELD OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEATHERLY",
        "authorized_official_first_name": "DEMIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-487-1203",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "12079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51520459",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.