Robert Alexander Wynn, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

056939 Issued in GA

Practice address

459 Highway 119 S
Springfield, GA 31329-3021

Phone

(912) 754-0382

Fax

(912) 754-0225

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Medical College of Georgia School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Surgical Providers, P.C.Group PAC ID 3274663091, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Effingham Health System Hospital, Springfield, GA, CCN 111306
• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Southern Surgical Providers, P.C.

  • Surgery Physician
  • Springfield, GA
  • NPI 1619203809
  Medicare reassignment Care Compare group NPD Authorized official
• Southern Surgical Providers, P.C.

  • Surgery Physician
  • Springfield, GA
  • NPI 1619398328
  NPD
• Cardiothoracic Surgery of Savannah PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Savannah, GA
  • NPI 1124183926
  NPD (past)

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

• Effingham Hospital, Inc.

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Care Compare affiliation
• Savannah Health Services, LLC

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1790748432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-754-0382",
            "fax_number": "912-754-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-754-0382",
            "fax_number": "912-754-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "ROBERT",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "056939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264241741A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Herman Mitchell Weitman, RPH
• Patricia White, RN
• Jennifer N Williams, PHARM.D.
• Peter Wolfenberger
• Shanell Wright, LPN

• Surgery Physician in Springfield, GA
• Providers in Springfield, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2024; 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.