Active NPI
Wyatt Ross Phipps
- Case Manager/Care Coordinator
- Pryor, OK
National Provider Identifier
1093636169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 4144 Redden
Pryor, OK 74361-9191 - Phone
- (918) 825-6825
- NPI assigned
- Jul 23, 2026
- Last updated
- Jul 23, 2026
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
4144 Redden
Pryor, OK 74361-9191
Mailing address
29809 E 155TH St S
Coweta, OK 74429-6016
Phone (918) 849-2857
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayes Emergency Services Trust Authority | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1093636169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29809 E 155TH ST S",
"city": "COWETA",
"state": "OK",
"postal_code": "744296016",
"telephone_number": "918-849-2857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4144 REDDEN",
"city": "PRYOR",
"state": "OK",
"postal_code": "743619191",
"telephone_number": "918-825-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPS",
"first_name": "WYATT",
"middle_name": "ROSS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-07-23",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.