Organization Active NPI

Gynecology & Wellness Center, P.C.

  • Health Service Clinic/Center
  • Auburn, AL
National Provider Identifier
1871615997
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
20979 Issued in AL
Legal business name
GYNECOLOGY & WELLNESS CENTER, P.C.
Practice address
2290 Moores Mill Road
Suite 200
Auburn, AL 36830
Phone
(334) 502-9888
Fax
(334) 502-9190
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Authorized official

Name
Tina M Gunnels
Title
Office Manager
Phone
(334) 502-9888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 20979 AL Primary

Addresses

Primary practice location

2290 Moores Mill Road
Suite 200
Auburn, AL 36830

Mailing address

2290 Moores Mill Road
Suite 200
Auburn, AL 36830
Phone (334) 502-9888

Other identifiers 1

IdentifierTypeStateIssuer
51503912OtherALBCBS OF AL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000563 AL Part B Supplier - Clinic/Group Practice 6305001868 Receives reassigned benefits from 1 practitioner
Practice locations: Auburn, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0998129Gynecology & Wellness Center2290 Moores Mill Road Suite 200, Auburn, AL 36830Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

2290 Moores Mill Rd
Ste 200
Auburn, AL 36830
Phone (334) 502-9888

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341532800000",
    "number": "1871615997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 MOORES MILL ROAD",
            "address_2": "SUITE 200",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-502-9888",
            "fax_number": "334-502-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 MOORES MILL ROAD",
            "address_2": "SUITE 200",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-502-9888",
            "fax_number": "334-502-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYNECOLOGY & WELLNESS CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-07-06",
        "status": "A",
        "authorized_official_last_name": "GUNNELS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-502-9888"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AL",
            "license": "20979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51503912",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.