Individual provider Active NPI

Nicole Elizabeth Wyatt

  • Nephrology Physician
  • Chapel Hill, NC
National Provider Identifier
1104389782
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2024-01766 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-1000
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO.2419 AL
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 2024-01766 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Other practice location 1

3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone (205) 971-5745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210909002417 AL Practitioner - Internal Medicine 8426454877 Reassigns benefits to 1 organization
I20240822002151 NC Practitioner - Nephrology 8426454877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

  • FMC Carolina Dialysis Carrboro Dialysis facility, Carrboro, NC, CCN 342622
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill Internal Medicine CurrentSince Jul 11, 2024 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Aug 1, 2021 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Aug 1, 2021 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

3070 Healthy Way
Vestavia, AL 35243
Phone (205) 977-7216

3325 Garden Rd
Ste B
Burlington, NC 27215
Phone (336) 538-4922

100 Eastowne Dr
Fl 56
Chapel Hill, NC 27514
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

102 Mason Farm Rd
Chapel Hill, NC 27514
Phone (919) 966-1459

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

Interoperability endpoints

  • Direct secure messaging: nwyatt1143281@direct.unc.nchie.net
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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.

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1104389782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3690 Grandview Pkwy",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352433326",
            "country_code": "US",
            "telephone_number": "205-971-5745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-07-01",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO.2419",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2024-01766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.