Carl Edward Wyne, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

3114301205 Issued in UT

Practice address

5770 Fashion Blvd
Murray, UT 84107-6548

Phone

(801) 314-4544

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Ihc Health Services Inc

  • Hospitalist Physician
  • Provo, UT
  • NPI 1134259294
  NPD (past)
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1821113887
  NPD (past)
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1114947223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-314-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076548",
            "telephone_number": "801-314-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNE",
        "first_name": "CARL",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "3114301205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preston Wright, DPT
• Walter Eldridge Wright III, SOCIAL WORKER
• Whitney Shea Wright, MD
• Julienne Wykstra
• James Derek Wylie, MD
• Alison E. Wynne, ARNP
• Amanda Wyrick
• Xiaoting Xiong
• Jasmine Yath
• Brayden Paul Yellman, M.D.

• Geriatric Medicine (Family Medicine) Physician in Murray, UT
• Providers in Murray, UT by specialty
• Geriatric Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.