GWENDOLYN T DEAN (NPI# 1629028386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629028386 |
| Entity Type | Individual |
| Full Name | GWENDOLYN T DEAN |
| Credential | M.D. |
| Practice Address |
115 Sumner Rd Fayetteville GA 30214-4758 |
| Mailing Address |
Po Box 56158 Atlanta GA 30343-0158 |
| Practice Telephone | 6784776904 |
| Mailing Telephone | 4043079575 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 28526 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00297349AL | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679905590 | Gwendolyn Alden Dean | Counselor | 2261 Elm St Bldg A, Napa, CA 94559-3721 | 2013-08-01 |
| Street Address |
115 SUMNER RD |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197812 | Kimberly G Luckman | Nurse Practitioner | 115 Sumner Rd, Fayetteville, GA 30214-4758 | 2019-10-29 |
| 1811198971 | Elizabeth Linville Bowen | Family Medicine | 115 Sumner Rd, Fayetteville, GA 30214-4758 | 2007-05-29 |
| 1447383351 | Kids Time Pediatrics of Southern Crescent, LLC | Pediatrics | 115 Sumner Rd, Suite D, Fayetteville, GA 30214-4758 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1962062240 | Shenika Twanet Judd | Specialist | 724 N Reilly Rd Ste C, Fayetteville, NC 28303-6042 | 2019-06-18 |
| 1033676358 | Suzanne Lynn Washburn | Specialist | 307 Barcelona Drive 26e, Fayetteville, NC 28303-5768 | 2019-02-22 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1194203075 | Dominique A Hunter | Specialist | 100 Hay St Fl 6, Fayetteville, NC 28301-5676 | 2018-08-01 |
| 1699286260 | Carla Jai Simmons | Specialist | 1300 Bragg Blvd Ste 1318, Fayetteville, NC 28301-4296 | 2017-10-23 |
| 1952825838 | Mary L Hill | Specialist | 185 Thornton Dr., Fayetteville, GA 30214 | 2017-08-01 |
| 1295288215 | Jillian Diffenbaugh | Specialist | 1019 Hay St, Fayetteville, NC 28305-5315 | 2016-07-26 |
| 1437534633 | Mark Hinton | Specialist | 131 Barnhill Arena Office, Office 116a, Fayetteville, AR 72701 | 2015-07-29 |
| 1841600830 | Trimana LLC | Specialist | 2875 E Joyce Blvd, Fayetteville, AR 72703-4524 | 2014-04-30 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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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.