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

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

Other identifiers 2

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

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 and National Provider Directory roles.

• West County Health Centers, Inc

  • 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.

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

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

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

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

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

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

  • 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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "ZZZ73222Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "NP13614",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West County Health Centers, Inc.
• West County Health Centers, Inc.
• West County Health Centers, Inc.
• Woodland Nature Therapy Licensed Clinical Social Worker, Inc.
• 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.