Wyatt D Woodard, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1235 Issued in AZ

Practice address

320 N Leroux St
Ste B
Flagstaff, AZ 86001-4535

Phone

(928) 779-0361

Fax

(928) 779-7143

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health of Arizona No 5 Home health agency, Flagstaff, AZ, CCN 037500
• Northern Arizona Home Health Home health agency, Flagstaff, AZ, CCN 037047
• Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
• Page Hospital Hospital, Page, AZ, CCN 031304

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wyatt.woodard.1@21579.direct.athenahealth.com

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

• Wyatt Woodard MSN FNP PC

  • Primary Care Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1720082621
  Medicare reassignment NPD Authorized official
• Wyatt Woodard MSN FNP PLLC

  • Family Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1578797122
  NPD (past) Authorized official
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  NPD (past)

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

• E Medical Group of Arizona No 5 LLC

  • Home Health Agency
  • Flagstaff, AZ
  • NPI 1730728502
  Care Compare affiliation
• Flagstaff Medical Center

  • Air Ambulance
  • Flagstaff, AZ
  • NPI 1427234111

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Land Ambulance
  • Flagstaff, AZ
  • NPI 1518143205

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875
  Care Compare affiliation
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  Care Compare affiliation
• LHCG Lxxvii, LLC

  • Home Health Agency
  • Flagstaff, AZ
  • NPI 1174983621
  Care Compare affiliation
• Page Hospital

  • Critical Access Hospital
  • Page, AZ
  • NPI 1578515789
  Care Compare affiliation

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1013911916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N LEROUX ST",
            "address_2": "STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014535",
            "telephone_number": "928-779-0361",
            "fax_number": "928-779-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N LEROUX ST",
            "address_2": "STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014535",
            "telephone_number": "928-779-0361",
            "fax_number": "928-779-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "WYATT",
        "middle_name": "D",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP1235",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip John Wong, O.D.
• Wei Xiang Wong
• Leonard A Wood, PT
• Ryan Wood, PA-C
• Katie Woodard, HEALTH COACH
• Woodlands Oral & Maxillofacial Surgery PC
• Woodlands Village Dentistry PC
• Megan M Woods, B.S
• Nicholas Woods, PT, DPT
• Sean Daniel Woods, M.D.

• Family Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.