Individual provider Active NPI

Connie Wyatt

  • Registered Dietitian
  • Wyomissing, PA
National Provider Identifier
1285081265
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN005416 Issued in PA
Practice address
1991 State Hill Rd
Wyomissing, PA 19610-1648
Phone
(484) 628-4270
Fax
(484) 628-4261
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN005416 PA Primary

Addresses

Primary practice location

1991 State Hill Rd
Wyomissing, PA 19610-1648

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Quality
77.19
Promoting interoperability
98
Improvement activities
40
Cost
79.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenixville Clinic Company LLC CurrentSince Sep 1, 2023 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Sep 1, 2023 Accepting new patients
Tower Health Medical Group CurrentSince Jun 29, 2016 Accepting new patients
Reading Hospital Current Accepting new patients
Tower Health Medical Group CurrentSince Jun 29, 2016 Accepting new patients
Reading Hospital CurrentSince Jan 4, 2023 Accepting new patients
Your Specialized Dietitian Dietitian, Registered Past Accepting new patients
Reading Professional Services Past Accepting new patients

Locations

420 W Linfield Trappe Rd
Ste 3100
Limerick, PA 19468
Phone (484) 750-3906

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

1220 Broadcasting Rd
Ste 100
Wyomissing, PA 19610
Phone (484) 628-5673

1991 State Hill Rd
Wyomissing, PA 19610
Phone (484) 628-4270

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1285081265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0796",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 STATE HILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101648",
            "telephone_number": "484-628-4270",
            "fax_number": "484-628-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN005416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.