Organization Active NPI

Round Two Medical Solutions LLC

  • Family Medicine Physician
  • Dothan, AL
National Provider Identifier
1881437762
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROUND TWO MEDICAL SOLUTIONS LLC
Doing business as
Renew Health Clinic
Practice address
105 S Woodburn Dr Ste 2
Dothan, AL 36305-1109
Phone
(334) 790-9872
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Dr. Philip Wilson, DONPI 1811256084
Title
Owner
Phone
(334) 790-9872

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

105 S Woodburn Dr Ste 2
Dothan, AL 36305-1109

Mailing address

107 Christen LN
Dothan, AL 36305-3140
Phone (334) 791-2406

Other names 1

  • Renew Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240823001346 AL Part B Supplier - Clinic/Group Practice 3870032725 Receives reassigned benefits from 2 practitioners
Practice locations: Dothan, 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
01D2314480Renew Health Clinic105 S Woodburn Drive, Ste 2, Dothan, AL 36305Certificate of waiverNov 19, 2026

National Provider Directory

National Provider Directory

Locations

105 S Woodburn Dr
Ste 2
Dothan, AL 36305
Phone (334) 649-3458

Practitioners & affiliated clinicians

Practitioners 2

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": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1881437762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHRISTEN LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363053140",
            "telephone_number": "334-791-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WOODBURN DR STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051109",
            "telephone_number": "334-790-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND TWO MEDICAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-790-9872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renew Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.