NPIMap

Individual provider Active NPI

Philip Wyatt, DO

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1184205221
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101027605 Issued in MI
Practice address
6465 Millennium Ste 100
Lansing, MI 48917-7831
Phone
(517) 975-3720
NPI assigned
Apr 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101027605 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X 5151014946 MI

Addresses

Primary practice location

6465 Millennium Ste 100
Lansing, MI 48917-7831

Mailing address

6465 Millennium Ste 100
Lansing, MI 48917-7831
Phone (517) 975-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240807004044 MI Practitioner - Internal Medicine 2062813769 Reassigns benefits to 1 organization
I20250811002398 CO Practitioner - Internal Medicine 2062813769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Group LLCGroup PAC ID 1052612785, 109 clinicians
Homedoc, PCGroup PAC ID 2961936927, 43 clinicians

Practice addresses (Care Compare)

607 28
Grand Junction, CO 81506-6018
Phone (970) 243-3300

8354 E Northfield Blvd
Suite 329
Denver, CO 80238-3131
Phone (720) 607-9207

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Grand Junction, CO, CCN 067196
  • Hopewest Grand Junction Hospice, Grand Junction, CO, CCN 061527
  • Community Hospital Hospital, Grand Junction, CO, CCN 060054
  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • La Villa Grande Care Center Nursing home, Grand Junction, CO, CCN 065253
  • Mantey Heights Rehabilitation & Care Center Nursing home, Grand Junction, CO, CCN 065307

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Community Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Colorado West Healthcare System CurrentSince Nov 1, 2025 Accepting new patients
McLaren Medical Group CurrentSince Aug 1, 2024 Accepting new patients
Colorado West Healthcare System CurrentSince Nov 1, 2025 Accepting new patients
Community Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Community Medical Group, LLC Internal Medicine Current Accepting new patients
Community Medical Group Past Accepting new patients

Locations

12805 Escanaba Dr
Ste 1
Dewitt, MI 48820
Phone (517) 913-3930

12805 Escanaba Dr
Ste 2
Dewitt, MI 48820
Phone (517) 367-5520

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

6465 Millennium
Ste 100
Lansing, MI 48917
Phone (517) 975-3720

Organizations & group practices 9

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1184205221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 MILLENNIUM STE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177831",
            "telephone_number": "517-975-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 MILLENNIUM STE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177831",
            "telephone_number": "517-975-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "PHILIP",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101027605",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151014946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.