Wanda L Wynn, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00961 Issued in IA

Practice address

4210 Pioneer Woods Dr
Ste a
Lincoln, NE 68506-7561

Phone

(402) 488-4321

Fax

(402) 488-4355

NPI assigned

Jun 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care Clinic of Lincoln PCGroup PAC ID 7214962455, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Urgent Care Clinic of Lincoln, P.C.

  • Urgent Care Clinic/Center
  • Lincoln, NE
  • NPI 1962408732
  Medicare reassignment Care Compare group
• Urgent Care Clinic of Lincoln, PC

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1114341948
  NPD

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1093719650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 PIONEER WOODS DR",
            "address_2": "STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067561",
            "telephone_number": "402-488-4321",
            "fax_number": "402-488-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 PIONEER WOODS DR",
            "address_2": "STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067561",
            "telephone_number": "402-488-4321",
            "fax_number": "402-488-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "WANDA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "00961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Nicole Wurtz
• Addison Nicole Wyatt
• Ashley Wyatt
• Jeffery Wyatt
• Ann M Wynegar, PA
• Antonette Wynne
• Lisa Wyrick
• William Wysocki, LIMHP
• Elizabeth Wysong Hoffart
• Zhi Xu, MD

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.