Mary Wyman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP13614 Issued in CA

Practice address

16319 Third Street
Guerneville, CA 95446

Phone

(707) 869-2849

Fax

(707) 869-1477

NPI assigned

Aug 1, 2006

Last updated

Nov 9, 2007By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIBEAA

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.

• West County Health Centers, Inc

  dba Sebastopol Community Health Center Building #2

  • Federally Qualified Health Center (FQHC)
  • Sebastopol, CA
  • NPI 1386524973
  NPD (past)
• West County Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Guerneville, CA
  • NPI 1528072386
  NPD (past)
• West County Health Centers, Inc.

  dba Russian River Health Center Bldg #2 Annex

  • Federally Qualified Health Center (FQHC)
  • Guerneville, CA
  • NPI 1215488705
  NPD (past)
• West County Health Centers, Inc.

  dba Russian River Health Center

  • Federally Qualified Health Center (FQHC)
  • Guerneville, CA
  • NPI 1356344758
  NPD (past)
• West County Health Centers, Inc.

  dba Sebastopol Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sebastopol, CA
  • NPI 1538334065
  NPD (past)
• West County Health Centers, Inc.

  dba Russian River Health Center Building #2

  • Federally Qualified Health Center (FQHC)
  • Guerneville, CA
  • NPI 1598786352
  NPD (past)
• West County Health Centers, Inc.

  dba Russian River Resiliency Center

  • Federally Qualified Health Center (FQHC)
  • Guerneville, CA
  • NPI 1649996554
  NPD (past)
• West County Health Centers, Inc.

  dba Gravenstein South

  • Federally Qualified Health Center (FQHC)
  • Sebastopol, CA
  • NPI 1841916889
  NPD (past)
• West County Health Centers, Inc.

  dba Gravenstein Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sebastopol, CA
  • NPI 1861809501
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1265449797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N MAIN ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723406",
            "telephone_number": "707-869-2849",
            "fax_number": "707-869-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16319 THIRD STREET",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "95446",
            "telephone_number": "707-869-2849",
            "fax_number": "707-869-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP13614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West County Health Centers, Inc. (Russian River Health Center)
• West County Health Centers, Inc. (Russian River Health Center Building #2)
• West County Health Centers, Inc. (Russian River Resiliency Center)
• Woodland Nature Therapy Licensed Clinical Social Worker, Inc. (Woodland Nature Therapy)
• Alexis Wylie, CMT
• Zoe Barnow, PSYD, a Psychological Corporation

• Family Nurse Practitioner in Guerneville, CA
• Providers in Guerneville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.