Mackenzie Wyatt

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

110972 Issued in GA

Practice address

4800 Sand Point Way NE
Seattle, WA 98105-3901

Phone

(615) 936-2555

Fax

(615) 936-3601

NPI assigned

Apr 11, 2020

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 WA

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 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1124647912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 FAIRFIELD DR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403539385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "615-936-2555",
            "fax_number": "615-936-3601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 N Druid Hills Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303293117",
            "country_code": "US",
            "telephone_number": "404-785-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-11",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "110972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James F Wuth, AUD
• Thomas Michael Wyant
• Wyatt T. Lee DDS PLLC
• Aislinn Wyatt, LCPO
• Jennifer Grace Wyatt, LMHC, MAC, SUDP
• Robert J. Wyatt, RN
• Stephanie Wyatt
• Thomas Gregory Wyatt, DO
• Kathryn Wyckoff, RN, MS, NP
• Nina Wycoff

• Pediatric Pulmonology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatric Pulmonology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.