Nelson Gwinn III, M.D.
Individual provider Active NPI Cardiovascular Disease Physician · Dothan, AL
NPI 1922087071 · NPPES record last updated Feb 3, 2011
Key facts
- NPI
- 1922087071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 15644 (AL)
- Practice address
- 1150 Ross Clark Cir
Dothan, AL 36301-3022 - Phone
- (334) 712-1929
- Fax
- (334) 712-2799
- NPI assigned
- Jan 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Medical University of South Carolina College of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeast Cardiology Clinic Inc.
Donalsonville Hospital Inc
The Hospital Authority of Miller County
Practice addresses (Care Compare)
1001 N Main St
Opp, AL 36467-1623
Phone (334) 493-3541
102 Hospital Cir
Donalsonville, GA 39845-1100
Phone 2295245217218
1146 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 712-1929
1150 Ross Clark Cir
Dothan, AL 36301-3022
2020 Alexander Dr
Dothan, AL 36301-3004
Phone (334) 712-1929
209 N Cuthbert St
Colquitt, GA 39837-3518
Phone (229) 758-4212
210 Westside Dr
Dothan, AL 36303-1928
Phone (334) 712-1929
218 Hospital Ave
Suite D
Ozark, AL 36360-2064
Phone (334) 712-1929
3700 Williams Dr
Marianna, FL 32446-7973
Phone (850) 482-9488
760 Columbia Rd
Suite a
Blakely, GA 39823-9796
Phone (334) 712-1929
Hospital & facility affiliations
- Southeast Health Medical Center
- Donalsonville Hospital Inc
- Jackson Hospital
- Dale Medical Center
- Miller County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in AL, FL, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110216000825 | AL | Practitioner - Cardiovascular Disease (Cardiology) | 1759308430 | Reassigns benefits to 2 organizations |
| I20111214000352 | FL | Practitioner - Cardiovascular Disease (Cardiology) | 1759308430 | Reassigns benefits to 1 organization |
| I20120724000542 | GA | Practitioner - Cardiovascular Disease (Cardiology) | 1759308430 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15644 | AL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiac Imaging Inc | Current |
Accepting new patients | |
| Donalsonville Hospital Inc | Current |
Accepting new patients | |
| The Hospital Authority of Miller County | Current | Accepting new patients | |
| The Hospital Authority of Miller County | Current | Accepting new patients | |
| Houston County Healthcare Authority | Cardiovascular Disease | Current |
Accepting new patients |
| Houston County Healthcare Authority | Current | Accepting new patients | |
| The Hospital Authority of Miller County | Current |
Accepting new patients | |
| The Hospital Authority of Miller County | Current |
Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635
11045 Columbia St
Blakely, GA 39823
Phone (228) 723-4313
209 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3385
102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489
804 N Wiley Ave
Donalsonville, GA 39845
Phone (229) 524-2808
Interoperability endpoints
- nelsongwinnsecardio@scc-al.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 15644 | AL | Yes |
Addresses
Primary practice location
1150 Ross Clark Cir
Dothan, AL 36301-3022
Mailing address
1150 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 712-1929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000088713 | Medicaid | AL | |
| 009941307 | Medicaid | AL | |
| 000055299 | Medicaid | AL | |
| 051088713 | Other | AL | BLUE CROSS |
| 051055299 | Other | AL | BLUE CROSS |
| 051538730 | Other | AL | BLUE CROSS |
| 61699 | Other | FL | BLUE CROSS |
| 529301110 | Medicaid | AL | |
| 258388700 | Medicaid | FL | |
| 631087996 | Other | TAX ID# | |
| 00459225B | Medicaid | GA | |
| 051540195 | Other | AL | BLUE CROSS |
| 054182600 | Medicaid | FL |
Other providers in Dothan, AL
- Gut Endo, LLC
- Gut PC
- Gut PC
- Ramaseetha Gutta
- Jimmie Guyton
- Nelson Jonathan Gwinn
- Traci Giles Hackett
- Lance Hagler
- Robert M Hagler
- Hairoglyphics Hair and Beauty Salon
All providers in Dothan, AL · Cardiovascular Disease Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.