WIREGRASS CLINIC LLC (NPI# 1558657890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558657890 |
| Entity Type | Organization |
| Organization Name | WIREGRASS CLINIC LLC |
| Practice Address |
4300 W Main St Suite 21 Dothan AL 36305-1054 |
| Mailing Address |
Po Box 689022 Franklin TN 37068-9022 |
| Practice Telephone | 3347945000 |
| Mailing Telephone | 6154657000 |
| Mailing Fax Number | 6156286877 |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES) |
| Authorized Official Telephone | 6157781502 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
4300 W MAIN ST SUITE 21 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740577 | Steven M. Fendley | Surgery | 4300 W Main St, Ste 24, Dothan, AL 36305-1054 | 2005-06-15 |
| 1649635434 | Leigh Phillips | Registered Nurse | 4300 W Main St, Suite 21, Dothan, AL 36305-1054 | 2015-12-21 |
| 1336514389 | Tri-state Urology, P.C. | Urology | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2015-12-02 |
| 1861870131 | Martin Plastic and Reconstructive Surgery, PC | Plastic Surgery | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2015-05-07 |
| 1811387053 | Eric M Warg | Registered Nurse | 4300 W Main St, 24, Dothan, AL 36305-1054 | 2015-01-26 |
| 1720426133 | Krystal Sims Fowler | Nurse Practitioner | 4300 W Main St, Suite 31, Dothan, AL 36305-1090 | 2013-06-07 |
| 1932497393 | Dothan Surgical Services, LLC | Surgery | 4300 W Main St, Dothan, AL 36305-1054 | 2011-07-19 |
| 1992096440 | Wiregrass Neurology, PC | Psychiatry & Neurology | 4300 W Main St, Suite 102, Dothan, AL 36305-1092 | 2011-05-02 |
| 1134426588 | Norma Faye Mcknight | Nurse Practitioner | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2011-02-22 |
| 1639305964 | Brooke E Sellers | Nurse Practitioner | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2009-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922243682 | Christopher Dwain Hargett | Neurological Surgery | 1812 E Main St, Dothan, AL 36301-3000 | 2008-12-10 |
| 1972798544 | Neurological Associates of Dothan | Neurological Surgery | 1118 Ross Clark Circle, Ste 301, Dothan, AL 36301 | 2007-09-07 |
| 1306898382 | Neuro Spine P C | Neurological Surgery | 1118 Ross Clark Cir, Suite 301, Dothan, AL 36301-3001 | 2006-05-17 |
| 1346245966 | David Bruce Woodham | Neurological Surgery | 4300 W Main St Ste 405, Dothan, AL 36305-1086 | 2005-06-20 |
| 1497750012 | Nicholas Frederick Voss | Neurological Surgery | 4300 W Main St Ste 405, Dothan, AL 36305-1086 | 2005-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720565351 | Faizal Aminmohamed Haji | Neurological Surgery | Lowder 400, 1600 7th Avenue South, Birmingham, AL 35233 | 2018-07-26 |
| 1558714121 | Neurology Center of East Alabama, LLC | Neurological Surgery | 2570 Village Professional Drive, Opelika, AL 36801-4742 | 2016-07-19 |
| 1689074825 | John Rainer | Neurological Surgery | 2415 Moores Mill Rd Unit 265, Auburn, AL 36830-8484 | 2014-08-25 |
| 1003226895 | James Davie | Neurological Surgery | 663 Idlewild Cir, Birmingham, AL 35205-5830 | 2014-05-01 |
| 1467792572 | Bluitt Lee Landers Jr. | Neurological Surgery | 5188 Crossings Pkwy, Birmingham, AL 35242-4538 | 2013-02-26 |
| 1205128790 | Richard Philip Menger | Neurological Surgery | 1604 Center Street, Ste 2s, Mobile, AL 36604-1541 | 2011-05-03 |
| 1477852739 | Ninh Ba Doan | Neurological Surgery | 2065 E South Blvd Ste 204, Montgomery, AL 36116-2460 | 2011-03-24 |
| 1780905380 | Joshua York Menendez | Neurological Surgery | 800 Saint Vincents Dr Ste 700, Birmingham, AL 35205-1630 | 2010-06-17 |
| 1598084394 | Jessica Nicole Bentley | Neurological Surgery | Jt727 619 19th St S, Birmingham, AL 35294 | 2010-05-19 |
| 1760717342 | Frank Phillip Haws | Neurological Surgery | 421 Mcclung Ave, Huntsville, AL 35801-3111 | 2009-10-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.