Individual provider Active NPI

Lori C Wyatt, MD

  • Family Medicine Physician
  • Greenville, TX
National Provider Identifier
1043570302
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP1-0044183 Issued in TX
Practice address
4400 I H 30 W Ste 100
Greenville, TX 75402-4620
Phone
(469) 800-3500
Fax
(469) 800-3510
NPI assigned
May 21, 2012
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP1-0044183 TX Primary

Addresses

Primary practice location

4400 I H 30 W Ste 100
Greenville, TX 75402-4620

Mailing address

4400 I H 30 W Ste 100
Greenville, TX 75402-4620
Phone (469) 800-3500

Other practice location 1

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 657-7583

Other identifiers 2

IdentifierTypeStateIssuer
8FE249OtherTXBCBS
348849601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150814013245 TX Practitioner - Family Practice 7810202264 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4400 Ih 30 W
100 Pca Greenville Family Practice
Greenville, TX 75402-4620
Phone (469) 800-3500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP1-0044183TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 26, 2024 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Jul 13, 2012 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 1, 2020 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 13, 2012 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

4400 Interstate Highway 30 W
Ste 100
Greenville, TX 75402
Phone (469) 800-3500

105 Zeid Blvd
Henderson, TX 75652
Phone (903) 315-5612

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: lwyatt1334636@direct.sw.org
  • Direct secure messaging: lwyatt14613@christushealth.direct-ci.net

Organizations & group practices 8

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 2

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1043570302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 I H 30 W STE 100",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754024620",
            "telephone_number": "469-800-3500",
            "fax_number": "469-800-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 I H 30 W STE 100",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754024620",
            "telephone_number": "469-800-3500",
            "fax_number": "469-800-3510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Zeid Blvd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "TX",
            "postal_code": "756526070",
            "country_code": "US",
            "telephone_number": "903-657-7583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "LORI",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP1-0044183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8FE249",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348849601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

Verify at the official NPI Registry.