Darryl Wheat, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C1490 Issued in MS

Practice address

106 Office Park Dr Ste D
Brandon, MS 39042-2404

Phone

(601) 613-5250

Fax

(601) 824-7775

NPI assigned

Jan 18, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fitness Clinic Wellness

  • Physical Therapist
  • Jackson, MS
  • NPI 1912352022
  Medicare reassignment NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194877068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WOODGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422285",
            "telephone_number": "601-613-5250",
            "fax_number": "601-824-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 OFFICE PARK DR STE D",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422404",
            "telephone_number": "601-613-5250",
            "fax_number": "601-824-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEAT",
        "first_name": "DARRYL",
        "name_prefix": "Dr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C1490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114348",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandy Patterson Wedgeworth, FNP-BC
• Tyler Eason Weeks, DMD
• Douglas R Welch, PHARMD
• Melinda Ann Wells, OWNER
• Misty M Westbrook, LPC
• White Transport Services LLC
• Dawn White, PTA
• Elizabeth Lawton White
• Makeba White
• Maleah R White

• Clinical Social Worker in Brandon, MS
• Providers in Brandon, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.