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Enrollment ID O20171002003306 resolves to a single NPI record. Open the full profile for complete detail.

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WW
NPI · 1013117167 · Active
Wiregrass Wellness Center, LLC
Psychiatry · Dothan, Alabama
Active
NPI
1013117167
Enrollment ID
O20171002003306
Taxonomy
2084P0800X
Type
Part B Supplier - Clinic/Group Practice

Medicare enrollment

This provider holds 3 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Part B Supplier

Source: CMS PECOS public enrollment file.

Secondary identifiers

Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.

Other

  • 0348462AL· Issued by CIGNA
  • 601701400AL· Issued by DOL
  • 774089000AL· Issued by MAGELLAN
  • 1013117167· Issued by NPI
  • 1080690FL· Issued by BEACON
  • 1104332527· Issued by NPI
  • 11498415· Issued by CAQH
  • 1811983596· Issued by NPI
  • 51521565AL· Issued by BCBS
  • 523314AL· Issued by VALUE OPTIONS
  • 19C1RAL· Issued by NEW DIRECTIONS
  • 50198FL· Issued by FLORIDA BLUE
  • 410459675AL· Issued by TRICARE
  • Q6YNLFL· Issued by FLORIDA BCBS

Source: NPPES public registry.

ReferenceAbout Medicare Enrollment IDs

A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.