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SOUTHEAST CARDIOLOGY CLINIC INC.
NPI 1285790915
Internal Medicine - Cardiovascular Disease in Dothan, AL

Active since December 28, 2006CLIA Certified · 7 labs
1150 ROSS CLARK CIR, DOTHAN, AL 36301(334) 712-1929(334) 712-2799 Get Directions Write a Review

NPPES record last updated: August 3, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southeast Cardiology Clinic Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST CARDIOLOGY CLINIC INC. (NPI 1285790915) is a healthcare organization registered as a cardiovascular disease in Dothan, Alabama and active in the NPI registry since December 2006. The organization holds 7 active CLIA laboratory certificates and lists Donna Bridwell, Insurance Supervisor, as its authorized official.

NPPES Registry Identity

NPI1285790915
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameSOUTHEAST CARDIOLOGY CLINIC INC.
Location Address1150 ROSS CLARK CIRDothan, AL 36301-3022
Mailing Address1150 Ross Clark CirDothan, AL 36301-3022 · (334) 712-1929 · Fax (334) 712-2799
Phone(334) 712-1929
Fax(334) 712-2799
Organization SubpartNo
Authorized OfficialDonna BridwellInsurance Supervisor · (334) 712-1929
Enumeration DateDecember 28, 2006
Last NPPES UpdateAugust 3, 2011
✔ NPI 1285790915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1150 ROSS CLARK CIR, Dothan, AL 36301
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Other Identifiers 18

Medicare PIN051558768AL
Medicaid258388700FL
Medicare PIN000088715AL
Medicare PIND718AL
Medicaid529301110AL
Medicare PIN051556107AL
Medicare PINF013AL
Medicare PINC30943GA
Medicare PIN000088713AL
Medicare PINI058AL
Medicare PIN000055299AL
Medicare PIN000055300AL
Medicare PIN000055301AL
Medicare PIN000095006AL
Medicare PIN24995FL
Medicare PIN000024479AL
Medicare PIN000095000AL
Medicare PINGRP2142GA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 7

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D0304803

Southeast Cardiology Clinic Inc · Dothan, AL
Active · expires Dec 22, 2027
CLIA Number01D0304803
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorNelson S. Gwinn MD
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic Inc1146 Ross Clark Circle SE, Dothan, AL 36301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2090701

Southeast Cardiology Clinic · Marianna, FL
Active · expires Jan 28, 2027
CLIA Number10D2090701
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorNelson S. Gwinn
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic4257 Lafayette Street, Marianna, FL 32446
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2090443

Southeast Cardiology Clinic · Donalsonville, GA
Active · expires Jan 22, 2027
CLIA Number11D2090443
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorNelson S. Gwinn
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic205 Bresee Street, Donalsonville, GA 39845
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D2090396

Southeast Cardiology Clinic · Ozark, AL
Active · expires Jan 21, 2027
CLIA Number01D2090396
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorNelson S. Gwinn
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic218 Hospital Ave Ste D, Ozark, AL 36360
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D2090398

Southeast Cardiology Clinic · Enterprise, AL
Active · expires Jan 21, 2027
CLIA Number01D2090398
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorNelson S. Gwinn
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic409 N Main Street, Enterprise, AL 36330
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D2090410

Southeast Cardiology Clinic · Troy, AL
Active · expires Jan 21, 2027
CLIA Number01D2090410
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorNelson S. Gwinn
Laboratory Phone(334) 712-1929
Laboratory LocationSoutheast Cardiology Clinic1340 Us 231 S Suite 2, Troy, AL 36081
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS YOUNG M.D.
Internal Medicine (Cardiovascular Disease)
1150 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 712-1929
DR. ANDREAS MUENCH M.D.
Internal Medicine (Cardiovascular Disease)
1150 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 712-1929
DR. CHRISTOPHER CENTAFONT D.O.
Internal Medicine (Cardiovascular Disease)
1150 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 712-1929
MRS. MARJORIE LOUISE JOHNSON CRNP
Nurse Practitioner (Family)
1150 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 712-1929
DR. NELSON GWINN III M.D.
Internal Medicine (Cardiovascular Disease)
1150 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 712-1929

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Cardiology Clinic Inc.'s NPI number?

The NPI number for Southeast Cardiology Clinic Inc. is 1285790915. It was assigned to this organization in the NPPES registry on December 28, 2006.

Where is Southeast Cardiology Clinic Inc. located?

Southeast Cardiology Clinic Inc. is located at 1150 Ross Clark Cir, Dothan, AL 36301. The listed phone number is (334) 712-1929.

What is Southeast Cardiology Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Southeast Cardiology Clinic Inc. hold CLIA laboratory certificates?

Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Southeast Cardiology Clinic Inc. accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Southeast Cardiology Clinic Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Cardiology Clinic Inc. was last updated on August 3, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.