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WIREGRASS CLINIC LLC
NPI 1427728393
Psychiatry & Neurology - Neurology in Dothan, AL

Active since September 14, 2021CLIA 01D0304775 · Waiver
348 HEALTHWEST DR, DOTHAN, AL 36303(334) 944-7006(334) 305-0076 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wiregrass Clinic Llc NPPES

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

WIREGRASS CLINIC LLC (NPI 1427728393) is a healthcare organization registered as a neurology in Dothan, Alabama and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through January 1, 2027 and lists Jennifer L Jackson, Sr Dir Prov Enrollment & Onboarding, as its authorized official.

NPPES Registry Identity

NPI1427728393
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameWIREGRASS CLINIC LLC
Location Address348 HEALTHWEST DRDothan, AL 36303-1907
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (877) 892-9815 · Fax (615) 628-6877
Phone(334) 944-7006
Fax(334) 305-0076
Organization SubpartYes
Authorized OfficialJennifer L JacksonSr Dir Prov Enrollment & Onboarding · (615) 465-3334
Enumeration DateSeptember 14, 2021
NPPES CertifiedSeptember 14, 2021
✔ NPI 1427728393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
348 HEALTHWEST DR, Dothan, AL 36303
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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 MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 01D0304775

Wiregrass Clinic LLC · Dothan, AL
Active · expires Jan 1, 2027
CLIA Number01D0304775
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorGabruce A. Young
Laboratory Phone(334) 794-5074
Laboratory LocationWiregrass Clinic LLC210 Westside Dr, Dothan, AL 36303
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

JUSTIN MATTHEW FETSKO DPT
Physical Therapist
348 HEALTHWEST DR
DOTHAN, AL 36303
Houston County (334) 699-5747
MRS. JENNIFER M PARRISH CRNP
Nurse Practitioner
348 HEALTHWEST DR
DOTHAN, AL 36303
Houston County (334) 944-7006
HASSAN KESSERWANI MD
Psychiatry & Neurology (Neurology)
348 HEALTHWEST DR
DOTHAN, AL 36303
Houston County (334) 944-7006

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 Wiregrass Clinic LLC's NPI number?

The NPI number for Wiregrass Clinic LLC is 1427728393. It was assigned to this organization in the NPPES registry on September 14, 2021.

Where is Wiregrass Clinic LLC located?

Wiregrass Clinic LLC is located at 348 Healthwest Dr, Dothan, AL 36303. The listed phone number is (334) 944-7006.

What is Wiregrass Clinic LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Does Wiregrass Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D0304775) is associated with this NPI, valid through January 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wiregrass Clinic LLC was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.