Individual provider Active NPI

Kathryn L Wyatt, N.P.

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1245361831
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-108437 Issued in AL
Practice address
4021 Balmoral Dr SW
Huntsville, AL 35801-6403
Phone
(256) 382-0070
Fax
(256) 382-0089
NPI assigned
Mar 8, 2007
Last updated
Apr 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-108437 AL Primary

Addresses

Primary practice location

4021 Balmoral Dr SW
Huntsville, AL 35801-6403

Mailing address

4021 Balmoral Dr SW
Huntsville, AL 35801-6403
Phone (256) 382-0070

Other identifiers 1

IdentifierTypeStateIssuer
1-108437OtherALSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831002372 AL Practitioner - Nurse Practitioner 6305921156 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Whitesport Dr SW
Huntsville, AL 35801-6449
Phone 2568815353117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12505TNMDPhysical Therapist
1-108437ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy,Asthma and Clinical Immunology Specialists, P.C. CurrentSince Apr 26, 2015 Accepting new patients
Allervie Health Professional Corporation CurrentSince Sep 1, 2024 Accepting new patients
Ear Nose Throat Head & Neck Surgery of Huntsville, P.C. CurrentSince Aug 1, 2025 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC Past Accepting new patients
Premier Allergist of Florida LLC PastSince Sep 1, 2024 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC PastSince Jan 1, 2000 Accepting new patients

Locations

2108 AL Highway 157
Cullman, AL 35058
Phone (256) 737-7339

504 Brookwood Blvd
Homewood, AL 35209
Phone (205) 209-4121

201 Whitesport Dr SW
Huntsville, AL 35801
Phone (256) 693-6863

4021 Balmoral Dr SW
Huntsville, AL 35801
Phone (256) 382-0070

4030 Pepperwood Cir SW
Huntsville, AL 35801
Phone (256) 539-6536

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kathryn.wyatt@aacis.direct.systemedx.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1245361831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-382-0070",
            "fax_number": "256-382-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-382-0070",
            "fax_number": "256-382-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-108437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1-108437",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.