Ashley Caroline Wyatt Wells, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

005983 Issued in GA

Practice address

2283 Wrightsboro Rd
Augusta, GA 30904-4717

Phone

(706) 733-3373

Fax

(706) 733-3423

NPI assigned

Oct 28, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ashley Caroline Wyatt Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Georgia Dermatology & Skin Cancer Center, LLC

  • Dermatology Physician
  • Dublin, GA
  • NPI 1063460459
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1245530989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD STE 21A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212890",
            "telephone_number": "478-275-7202",
            "fax_number": "478-274-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2283 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044717",
            "telephone_number": "706-733-3373",
            "fax_number": "706-733-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT WELLS",
        "first_name": "ASHLEY",
        "middle_name": "CAROLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005983",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005983",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "005983",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003101516",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "005983",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WYATT",
            "middle_name": "CAROLINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wrightsboro Medical Center
• Wrightsboro Physician Services LLC
• Hanping Wu, MD
• Yan Wu, OD
• Jean-Paul Wuilleumier, M.D.
• April Wyatt, FNP-C
• Caitlyn Wyatt
• Kristal F. Wyatt, OTR/L
• Hollis Sherman Wylie, DO
• Robert Lowry Wylie V, MD

• Medical Physician Assistant in Augusta, GA
• Providers in Augusta, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.