WYATT CLINIC, P.A. (NPI# 1639280431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639280431 |
| Entity Type | Organization |
| Organization Name | WYATT CLINIC, P.A. |
| Practice Address |
1411 E Amarillo Blvd Amarillo TX 79107-5555 |
| Mailing Address |
1411 E. Amarillo Blvd. Amarillo TX 79107-5555 |
| Practice Telephone | 8063517200 |
| Practice Fax Number | 8063517274 |
| Mailing Telephone | 8063541015 |
| Mailing Fax Number | 8063517274 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-03-30 |
| Authorized Official Name | MS. CAROLYN SUE HURT (CPMSM, CPCS) |
| Authorized Official Telephone | 8063558900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 168039901 | 05 |
| Street Address |
1411 E AMARILLO BLVD |
| City | AMARILLO |
| State | TX |
| Zip Code | 79107-5555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726212 | Jeffrey S Pickens | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2005-11-08 |
| 1760030100 | Jennifer Kathryn Ebeling | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-08-29 |
| 1073175154 | Todd M Walls | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-06-28 |
| 1245796911 | William Bowman | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-02-18 |
| 1427523737 | Meredith Mercer | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2018-10-12 |
| 1043766272 | Blanca Rangel | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-08-28 |
| 1063863314 | Brandi Lehning | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-06-28 |
| 1770903304 | Whitney L Dowd | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2014-04-22 |
| 1780008904 | Northwest Texas Wyatt Clinic Pllc | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2014-02-07 |
| 1578998951 | Cecelia Garcia Brewer | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2013-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851738884 | Daniel J Meadors | Dentist | 2201 N. Grand, Amarillo, TX 79107 | 2013-05-31 |
| 1568660785 | Keelie Nicole Hauk | Dental Hygienist | 850 Martin Road, Amarillo, TX 79107 | 2007-07-10 |
| 1346361664 | Daniel J Meadors Dds Inc | Dentist | 2201 N Grand, Amarillo, TX 79107 | 2007-04-03 |
| 1881701795 | John C Curry | Dentist | 2201 N Grand St, Amarillo, TX 79107 | 2006-08-24 |
| 1285633305 | Kathy Ann Ford | Nurse Practitioner | 824 Martin Rd, Amarillo, TX 79107 | 2005-07-20 |
| 1629572854 | Ihnbae Cho | Dentist | 206 Ne 7th Ave, Amarillo, TX 79107 | 2018-03-21 |
| 1467736363 | Maria Fernanda Contreras | Pediatrics | 713 N Taylor St, Amarillo, TX 79107 | 2011-10-11 |
| 1477735322 | Timothy John Revell | Emergency Medicine | 9601 Spur 591, Amarillo, TX 79107 | 2007-12-03 |
| 1851309280 | John Michael Archer | Dentist | 1900 Coulter Road, Suite G, Amarillo, TX 79107-1732 | 2006-08-03 |
| 1386067593 | Amber Leigh Roth | Nurse Practitioner | 1411 East Amarillo Blvd, Amarillo, TX 79107-1770 | 2014-01-23 |
| Find all providers in zip 79107 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760949200 | Joy Medical Clinic Pllc | Family Medicine | 4310 S Western St Unit E, Amarillo, TX 79109-6036 | 2019-02-20 |
| 1679929723 | Megan Maguire Marshall Scott | Family Medicine | Regence Health Network, 3113 Ross St., Amarillo, TX 79103 | 2016-05-08 |
| 1013276088 | Fmc Medical Foundation, Inc. | Family Medicine | 7306 Sw 34th Ave, Unit 4, Amarillo, TX 79121-1423 | 2012-05-11 |
| 1629364435 | Sarah Christine Lozano | Family Medicine | 1900 S Coulter St Ste A, Amarillo, TX 79106-1785 | 2011-06-21 |
| 1508151309 | Anastacia J Nix | Family Medicine | 2329 Ross Osage St, Amarillo, TX 79103 | 2011-06-09 |
| 1932350550 | Preventative Healthcare Institute, LLC | Family Medicine | 1920 Medi Park Dr Ste 2, Amarillo, TX 79106-2111 | 2008-10-01 |
| 1750562450 | Drs. Stout & Cotton | Family Medicine | 2300 W 7th Ave, Amarillo, TX 79106-6623 | 2007-11-21 |
| 1861689572 | Cristiane Campos Ennis | Family Medicine | 1901 Medi Park Dr 103, Amarillo, TX 79106-2106 | 2007-09-26 |
| 1043405913 | Wesley Scott Nickens | Family Medicine | 603 Quail Creek Dr Spc 300, Amarillo, TX 79124 | 2007-09-12 |
| 1336360452 | Earl C. Hoffer | Family Medicine | Pantex Plant Fm 2373 At Hwy 60, Amarillo, TX 79120 | 2007-05-02 |
| Find all providers in AMARILLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.