NPIMap

Individual provider Active NPI

Molly Jackson Gwin, CRNP

  • Family Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1831813120
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0722137 Issued in AL
Practice address
100 Rice Mine Rd N Ste 100
Tuscaloosa, AL 35406-3905
Phone
(205) 349-4200
Fax
(205) 558-9190
NPI assigned
Sep 29, 2022
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0722137 AL Primary

Addresses

Primary practice location

100 Rice Mine Rd N Ste 100
Tuscaloosa, AL 35406-3905

Mailing address

100 Rice Mine Rd N Ste 100
Tuscaloosa, AL 35406-3905
Phone (205) 349-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712003291 AL Practitioner - Nurse Practitioner 0941660716 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hale County HospitalGroup PAC ID 3375528169, 19 clinicians
Relias Emergency Medicine Specialists of Regional, LLCGroup PAC ID 9436401106, 29 clinicians

Practice addresses (Care Compare)

1601 University Blvd E
Tuscaloosa, AL 35404-2920
Phone (205) 349-2273

508 Greene St
Suite 2
Greensboro, AL 36744-2316
Phone (334) 624-3024

809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0722137ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Relias Emergency Medicine Specialists of Fayette, LLC CurrentSince Jan 1, 2023 Accepting new patients
Hale County Hospital CurrentSince Sep 6, 2023 Accepting new patients
Internal Medicine Associates of Tuscaloosa, PC CurrentSince Oct 2, 2022 Accepting new patients
Southeast Physician Network, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Hale County Hospital CurrentSince Sep 6, 2023 Accepting new patients
Southeast Physician Network, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Internal Medicine Associates of Tuscaloosa, P.C. CurrentSince Oct 2, 2022 Accepting new patients
Relias Emergency Medicine Specialists of Regional, LLC CurrentSince May 31, 2023 Accepting new patients
Relias Emergency Medicine Specialists of Northport, LLC CurrentSince May 31, 2023 Accepting new patients
Hale County Hospital Past Accepting new patients

Locations

1653 Temple Ave N
Fayette, AL 35555
Phone (205) 759-7063

508 Greene St
Greensboro, AL 36744
Phone (334) 624-3024

508 Greene St
#2
Greensboro, AL 36744
Phone (334) 624-3024

508 Greene St
Ste A
Greensboro, AL 36744

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

100 Rice Mine Rd N
Ste 100
Tuscaloosa, AL 35406
Phone (205) 349-4200

1601 University Blvd E
Tuscaloosa, AL 35404
Phone (205) 349-2273

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Interoperability endpoints

  • Direct secure messaging: molly.gwin.1@12717.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1831813120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N STE 100",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063905",
            "telephone_number": "205-349-4200",
            "fax_number": "205-558-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N STE 100",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063905",
            "telephone_number": "205-349-4200",
            "fax_number": "205-558-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIN",
        "first_name": "MOLLY",
        "middle_name": "JACKSON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "F0722137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.