Erika Wyatt, RECOVERY ASSISTANT

Individual provider Active NPI Case Manager/Care Coordinator · Benton, AR

NPI 1083068951 · NPPES record last updated Apr 18, 2016

Key facts

NPI
1083068951
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
6701 Highway 67 BLDG 4
Benton, AR 72015-8909
Phone
(501) 315-3344
NPI assigned
Apr 18, 2016
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR Yes

Addresses

Primary practice location

6701 Highway 67 BLDG 4
Benton, AR 72015-8909

Mailing address

PO Box 1589
Benton, AR 72018-1589
Phone (501) 315-3344

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 18, 2016.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1083068951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181589",
            "telephone_number": "501-315-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 HIGHWAY 67 BLDG 4",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720158909",
            "telephone_number": "501-315-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "ERIKA",
        "credential": "RECOVERY ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

All providers in Benton, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.