Individual provider Active NPI

Jacob Wesley Guin, MD

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1861055121
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.41843 Issued in AL
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone
(205) 348-1770
Fax
(205) 348-1772
NPI assigned
Apr 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.41843 AL Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Other practice location 1

289 Robert K. Wilson Dr
Carrollton, AL 35447-3544
Phone (205) 463-1350

Other identifiers 1

IdentifierTypeStateIssuer
289004MedicaidAL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220725000052 AL Practitioner - Family Practice 3971931585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Carrollton, AL, CCN 017092
  • Amedisys Home Health of Reform Home health agency, Carrollton, AL, CCN 017078
  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.41843ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Health Services Foundation PC Family Medicine CurrentSince Jul 18, 2022 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Jul 18, 2022 Accepting new patients

Locations

289 Robert K Wilson Dr
Ste C
Carrollton, AL 35447

289 Robert K Wilson Dr
Carrollton, AL 35447
Phone (205) 463-1350

850 Peter Bryce Blvd
Ste 300
Tuscaloosa, AL 35401

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

Interoperability endpoints

  • Direct secure messaging: jacob.guin.p1@direct.umc.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1861055121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-1772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Robert K. Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "AL",
            "postal_code": "354473544",
            "country_code": "US",
            "telephone_number": "205-463-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUIN",
        "first_name": "JACOB",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.41843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289004",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.