Nathan Shane Wyatt, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

13255 Issued in OK

Practice address

1201 S Belmont Ave
Baker Building - Suite 106
Okmulgee, OK 74447

Phone

(918) 756-9909

Fax

(918) 756-2464

NPI assigned

Feb 20, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

Practice roles

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.

• Indian Health Service Richmond Service Unit

  • Clinic/Center
  • Charles City, VA
  • NPI 1013523307
  NPD (past)
• Indian Health Service Richmond Service Unit

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Charles City, VA
  • NPI 1619548526
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1114062908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S BELMONT AVE STE 106",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476351",
            "telephone_number": "918-756-9909",
            "fax_number": "918-756-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S BELMONT AVE",
            "address_2": "BAKER BUILDING - SUITE 106",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "74447",
            "telephone_number": "918-756-9909",
            "fax_number": "918-756-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "NATHAN",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Ray Wilson, OTR/L
• Rebecca Lynn Wollet, COTA/L
• Wonderfully Made Therapy Group, LLC
• Cristi Lynn Woodard
• Mariah Worley
• Yaerger Dental
• Jerod Don Yaerger, D.D.S
• Dawn Yahola
• Linda Z. Yeager, LPC
• Madalynn Elaine Young, M.A.M.F.L.

• Pharmacist in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.