NPIMap

Organization Active NPI

Wiregrass Neurology, PC

  • Neurology Physician
  • Dothan, AL
National Provider Identifier
1992096440
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
30759 Issued in AL
Legal business name
WIREGRASS NEUROLOGY, PC
Practice address
4300 W Main St
Suite 102
Dothan, AL 36305-1092
Phone
(334) 793-9564
Fax
(334) 671-8907
NPI assigned
May 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Authorized official

Name
Mrs. Melissa W Reeves
Title
Administrator
Phone
(334) 793-9564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 30759 AL Primary

Addresses

Primary practice location

4300 W Main St
Suite 102
Dothan, AL 36305-1092

Mailing address

4300 W Main St
Suite 102
Dothan, AL 36305-1092
Phone (334) 793-9564

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBCABD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1992096440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051092",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051092",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIREGRASS NEUROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-793-9564",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "30759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.