Individual provider Active NPI

Gavin Ray Wilks, M.D.

  • Surgery Physician
  • Tuscaloosa, AL
National Provider Identifier
1992063879
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
38426 Issued in AL
Practice address
701 University Blvd E Ste 604
Tuscaloosa, AL 35401-7411
Phone
(205) 759-6925
Fax
(205) 759-6926
NPI assigned
Apr 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 38426 AL Primary

Addresses

Primary practice location

701 University Blvd E Ste 604
Tuscaloosa, AL 35401-7411

Mailing address

518 County Road 154
Crossville, AL 35962-4217
Phone (256) 572-0812

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
I20191008000877 AL Practitioner - General Surgery 5890931596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Alabama Physician Associates LLCGroup PAC ID 3476620311, 36 clinicians

Practice addresses (Care Compare)

701 University Blvd E
Suite 604
Tuscaloosa, AL 35401-2092
Phone (205) 759-6925

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Alabama Physician Associates LLC CurrentSince Aug 1, 2019 Accepting new patients
The DCH Healthcare Authority CurrentSince Aug 5, 2022 Accepting new patients
West Alabama Physician Associates, LLC CurrentSince Aug 1, 2019 Accepting new patients
West Alabama Physician Associates, LLC Current Accepting new patients
The DCH Health Care Authority CurrentSince Aug 5, 2022 Accepting new patients

Locations

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

701 University Blvd E
Ste 604
Tuscaloosa, AL 35401
Phone (205) 759-6925

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

701 University Blvd E
Ste 602
Tuscaloosa, AL 35401
Phone (205) 758-6611

Organizations & group practices 5

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 3

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1992063879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 COUNTY ROAD 154",
            "city": "CROSSVILLE",
            "state": "AL",
            "postal_code": "359624217",
            "telephone_number": "256-572-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 604",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017411",
            "telephone_number": "205-759-6925",
            "fax_number": "205-759-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "GAVIN",
        "middle_name": "RAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "38426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.