Individual provider Active NPI

Savanna Wynn, APRN

  • Family Nurse Practitioner
  • Harlan, KY
National Provider Identifier
1013468222
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010816 Issued in KY
Practice address
132 Village Center Rd
Harlan, KY 40831-1777
Phone
(606) 573-7771
NPI assigned
Oct 24, 2016
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3010816 KY Primary

Addresses

Primary practice location

132 Village Center Rd
Harlan, KY 40831-1777

Mailing address

PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129000490 KY Practitioner - Nurse Practitioner 2961782461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Cardinal Health PLLCGroup PAC ID 3375011968, 9 clinicians

Practice addresses (Care Compare)

132 Village Ctr Rd
Harlan, KY 40831-1777
Phone (606) 573-7771

9600 Lamborne Blvd
Louisville, KY 40272-2505
Phone (385) 207-9919

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3010816KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Health Corporation Current Accepting new patients
Mountain Comprehensive Health Corporation CurrentSince Oct 24, 2016 Accepting new patients
Mountain Comprehensive Health Corporation Family Current Accepting new patients
Mountain Comprehensive Health Corporation Current Accepting new patients
Mountain Comprehensive Health Corporation Family CurrentSince Oct 24, 2016 Accepting new patients
Mountain Comprehensive Health Corporation Past Accepting new patients

Locations

826 Ky 11 N
Booneville, KY 41314
Phone (606) 593-6395

72 Buckhorn Clinic Rd
Buckhorn, KY 41721
Phone (606) 398-7141

464 KY Highway 699
Cornettsville, KY 41731
Phone (606) 476-2450

1620 E Main St
Cumberland, KY 40823
Phone (606) 589-6113

132 Village Center Rd
Harlan, KY 40831
Phone (606) 573-2004

105 Isom Plz
Jeremiah, KY 41826
Phone (606) 633-2233

1530 US Highway 25 E
Middlesboro, KY 40965
Phone (606) 654-9450

251 S Pine St
Pineville, KY 40977
Phone (606) 337-3500

226 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871

Interoperability endpoints

  • Direct secure messaging: savanna.wynn.p1@direct.mtncomp.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1013468222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040",
            "telephone_number": "606-633-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 VILLAGE CENTER RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311777",
            "telephone_number": "606-573-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "SAVANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

Verify at the official NPI Registry.