Marlyn Brian Wyatt, DPT, RN

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5774 Issued in NM

Practice address

845 Sullivan Ave
Farmington, NM 87401-7356

Phone

(505) 278-8295

Fax

(505) 436-2077

NPI assigned

Jan 23, 2020

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

Enrolled in NM

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Baylor College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

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.

• Rock Physical Therapy Resilience & Training Center PC

  • Physical Therapy Clinic/Center
  • Farmington, NM
  • NPI 1164038204

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Tomsic Physical Therapy, Inc.

  • Physical Therapist
  • Durango, CO
  • NPI 1821178195
  NPD

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1194355719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 SULLIVAN AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874017356",
            "telephone_number": "505-278-8295",
            "fax_number": "505-436-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SULLIVAN AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874017356",
            "telephone_number": "505-278-8295",
            "fax_number": "505-436-2077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 Rivergate Unit 97",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813017490",
            "country_code": "US",
            "telephone_number": "970-259-0574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MARLYN",
        "middle_name": "BRIAN",
        "credential": "DPT, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Joanna Wooten, NP-C
• Julie Ana Wortman, LMT
• Jeannie Marie Wright, LMSW
• Melissa Wright
• Pamela J Wright
• Tanuja Yalamarti
• Tawnya Marie Yarbro, NM LMT #2737
• Brunhilda G Yazzie
• Heather C Yazzie
• Shundiina Yazzie

• Physical Therapist in Farmington, NM
• Providers in Farmington, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.