Active NPI
Shawn Andrew Wygant, MA
- Forensic Psychologist
- Oscoda, MI
National Provider Identifier
1023844743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 6352000017
- Practice address
- 208 Ottawa CT
Oscoda, MI 48750-1462 - Phone
- (989) 335-5134
- Fax
- (989) 739-1417
- NPI assigned
- Sep 10, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 6352000017 | MI | Primary |
Addresses
Primary practice location
208 Ottawa CT
Oscoda, MI 48750-1462
Mailing address
208 Ottawa CT
Oscoda, MI 48750-1462
Phone (989) 335-5134
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6352000017 | MI | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1023844743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 OTTAWA CT",
"city": "OSCODA",
"state": "MI",
"postal_code": "487501462",
"telephone_number": "989-335-5134",
"fax_number": "989-739-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 OTTAWA CT",
"city": "OSCODA",
"state": "MI",
"postal_code": "487501462",
"telephone_number": "989-335-5134",
"fax_number": "989-739-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYGANT",
"first_name": "SHAWN",
"middle_name": "ANDREW",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-10",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MI",
"license": "6352000017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oscoda, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.