DR. AUSTIN RYAN GAULDIN (DO) – Family Medicine Physician, NPI 1174103303

DR. AUSTIN RYAN GAULDIN (DO) is a healthcare provider. based in Tupelo, Mississippi. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. DO.3817 (AL). The NPI Number for DR. AUSTIN RYAN GAULDIN (DO) is 1174103303

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. AUSTIN RYAN GAULDIN (DO)
NPI
1174103303
Phone
(662) 377-2189
Address
1665 S GREEN ST
Enumeration Date
12 April 2021
Last Update Date
18 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2056709690
Graduation Year
2021 (5 years ago)
PAC ID
4183027352
Group Practice PAC ID
4385651751
Professional Enrollment ID
I20241203001513
Address ID
AL350519701CO247XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

941 FAMILY PRACTICE in MS

Provider Addresses for DR. AUSTIN RYAN GAULDIN (DO)

  • 1665 S GREEN ST

    TUPELO, MS 388046556

    Phone: (662) 377-2189

    Type: Mailing

  • 247 WALTON ST

    COLUMBIANA, AL 350516556

    Phone: (205) 670-9690

    Fax: (205) 670-9709

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $221.

Total Amount is formed as General ($221) + Research ($0) + Ownership ($0) = $221.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($46).

Total Amount

$221

General + Research + Ownership

Payments

11

Total payment records

General Amount

$221

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-03

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241203001513IFamily PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38804)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385651751View full group profile
NameSpecialtyState
-AL
-AL
O B S T E T R I C S/ G Y N E C O L O G YAL
Nurse PractitionerAL
Internal MedicineAL
Endocrinology, Internal MedicineAL
-AL
O B S T E T R I C S/ G Y N E C O L O G YAL
Orthopedic SurgeryAL
Internal MedicineGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. AUSTIN RYAN GAULDIN (DO)?
DR. AUSTIN RYAN GAULDIN (DO) — NPI 1174103303 — is the standard way to identify this listing.
Can I rely on DR. AUSTIN RYAN GAULDIN (DO) being an active provider?
As of the registry snapshot, DR. AUSTIN RYAN GAULDIN (DO) is marked active.
What healthcare role does DR. AUSTIN RYAN GAULDIN (DO) hold?
Scheduling teams often label DR. AUSTIN RYAN GAULDIN (DO) under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. AUSTIN RYAN GAULDIN (DO) based?
DR. AUSTIN RYAN GAULDIN (DO) is tied to Tupelo, Mississippi in the data we show; additional addresses may exist on the full record.
Is the information about DR. AUSTIN RYAN GAULDIN (DO) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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