Individual provider Active NPI

Antoinette Cheryl Wyatt

  • Social Worker
  • Atlantic City, NJ
National Provider Identifier
1023765211
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
083349-01 Issued in NY
Practice address
351 N New Hampshire Ave Apt 503
Atlantic City, NJ 08401-2975
Phone
(917) 743-6760
NPI assigned
Mar 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 083349-01 NY Primary

Addresses

Primary practice location

351 N New Hampshire Ave Apt 503
Atlantic City, NJ 08401-2975

Mailing address

351 N New Hampshire Ave Apt 503
Atlantic City, NJ 08401-2975
Phone (917) 743-6760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
083349-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1023765211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 N NEW HAMPSHIRE AVE APT 503",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084012975",
            "telephone_number": "917-743-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 N NEW HAMPSHIRE AVE APT 503",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084012975",
            "telephone_number": "917-743-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "ANTOINETTE",
        "middle_name": "CHERYL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083349-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.