DR. NELSON GWINN III M.D.
NPI 1922087071
Internal Medicine - Cardiovascular Disease in Dothan, AL

Q: What is Nelson Gwinn's NPI number?

The NPI number for Nelson Gwinn is 1922087071. It was assigned to this individual provider in the NPPES registry on January 16, 2006.

Q: What is Nelson Gwinn's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nelson Gwinn was last updated on February 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since January 16, 2006PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

1150 ROSS CLARK CIR, DOTHAN, AL 36301(334) 712-1929(334) 712-2799 Get Directions Write a Review

NPPES record last updated: February 3, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Nelson Gwinn Iii M.d. NPPES

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

DR. NELSON GWINN III M.D. (NPI 1922087071) is an individual cardiovascular disease provider in Dothan, Alabama, licensed in Alabama (15644) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson Hospital, and is a graduate of Medical University Of South Carolina College Of Medicine (1985).

NPPES Registry Identity

NPI1922087071

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. NELSON GWINN IIICredential: M.D.

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

Sole ProprietorNo

Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 1985

Enumeration DateJanuary 16, 2006

Last NPPES UpdateFebruary 3, 2011

✔ NPI 1922087071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in AL · 15644

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 20

Other61699FL · Blue Cross

Other051055299AL · Blue Cross

Medicaid00459225BGA

Medicaid000055299AL

Medicaid009941307AL

Other631087996Tax Id#

Medicaid054182600FL

Other051088713AL · Blue Cross

Medicare PIN000038730AL

Medicare PIN61699YFL

Other051538730AL · Blue Cross

Medicaid258388700FL

Medicare PIN060018109GA

Medicare PIN000055299AL

Medicare ID-Type Unspecified000088713AL

Medicare PINGRP2142GA

Medicare UPINC84237AL

Other051540195AL · Blue Cross

Medicaid000088713AL

Medicaid529301110AL

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nelson Gwinn Iii M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759308430

PECOS Enrollment IDI20110216000825, I20111214000352, I20120724000542

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 36

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

6,406 services852 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

3,159 services1,782 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

3,120 services1,846 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

1,394 services1,380 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

1,212 services300 patients

Technetium tc-99m sestamibi, diagnostic, per study dose A9500

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

719 services360 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

645 services360 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

360 services360 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

359 services359 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

265 services103 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

236 services87 patients

Natriuretic peptide (heart and blood vessel protein) level 83880

A natriuretic peptide level test is a blood test that helps doctors check for heart failure. It measures the amount of certain proteins that your heart and blood vessels produce when they are under stress. High levels may indicate heart disease.

235 services221 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

233 services233 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

205 services29 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

153 services136 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

150 services149 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

145 services143 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

103 services103 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

95 services12 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

81 services80 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

78 services78 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

67 services63 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

60 services59 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

This is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.

57 services57 patients

Nuclear medicine study of heart muscle blood flow by pet 78434

A nuclear medicine study of heart muscle blood flow by PET is a non-invasive test that uses a small amount of radioactive substance to create detailed images of your heart's blood flow and function. It helps assess heart health and diagnose heart conditions.

57 services57 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

46 services46 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

35 services34 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services27 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

24 services24 patients

Ultrasound of heart during rest, exercise and/or drug-induced stress with report 93350

This procedure involves using ultrasound imaging to view your heart at rest, during exercise, and/or under drug-induced stress. It helps assess how well your heart responds to exertion. A report of the findings is provided after the test.

23 services23 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

22 services22 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

20 services20 patients

Programming of dual lead pacemaker system 93280

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

15 services15 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

15 services15 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system 93288

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

12 services12 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Hospital

Acute Care Hospitals · Marianna, FL

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100142

Location4250 Hospital DrMarianna, FL 32446 · Jackson County

Emergency services Birthing friendly

Donalsonville Hospital Inc

Acute Care Hospitals · Donalsonville, GA

OwnershipVoluntary non-profit - Private

CMS Certification Number110194

Location102 Hospital CirDonalsonville, GA 39845 · Seminole County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$122.31 typical visit price

range $52.65 – $161.63

Typical copayment $30.57 (range $13.16 – $40.40)

Most-billed visit code 99204

Established Patient

$66.08 typical visit price

range $16.56 – $131.65

Typical copayment $16.52 (range $4.14 – $32.91)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

70%995 patients3/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

97%9,476 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

100%7,716 patients5/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

97%6,903 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

53%4,505 patients3/55-star benchmark: 99%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 99% · 3,030 patients

Patients tobacco: 95% · 3,030 patients

62%361 patients3/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

46%4,505 patients2/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%4,505 patients1/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 3,000 patients

0%3,000 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers13 claims13 services$78.25 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers12 claims36 services$32.00 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers18 claims18 services$19.99 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers21 claims126 services$2.87 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers13 claims13 services$21.29 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$768.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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)