Active NPI
Matthew Wynne, MD
- Emergency Medicine Physician
- Jackson, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 53625
- Practice address
- 620 Skyline Dr
Jackson, TN 38301-3923 - Phone
- (731) 541-5000
- Fax
- (731) 410-0367
- NPI assigned
- Mar 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD0000053625 | TN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 53625 | TN | Primary |
Addresses
Primary practice location
620 Skyline Dr
Jackson, TN 38301-3923
Mailing address
620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000
Other practice location 1
294 Summar Dr
Jackson, TN 38301-3915
Phone (731) 423-1932 ext. 323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Tennessee, HSC, College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2986 Kate Bond Rd
Bartlett, TN 38133-4003
Phone (901) 820-7000
7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-6000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53625 | TN | MD | Emergency Medicine Physician |
| MD0000053625 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Central Physicians PLLC | Current | Accepting new patients | |
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
| Methodist North Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| University of Tennessee | Family Medicine | Current | Accepting new patients |
| Methodist South Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| WT University Medical Associates Inc | Family Medicine | Current | Accepting new patients |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Erx Group, LLC | Emergency Medicine | Current | Accepting new patients |
| University of Tennessee | Current | Accepting new patients | |
| Concord Medical Group of Texas PLLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Medical Care Facilities PC | Emergency Medicine | Current | Accepting new patients |
| Concord Medical Group PLLC | Emergency Medicine | Current | Accepting new patients |
| Germantown Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| Methodist University Emergency Physicians PLLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Coverage Services, PC | Past | Accepting new patients |
Locations
2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000
9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000
3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200
1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362
1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700
7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290
326 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200
451 Highway 13 S
Waverly, TN 37185
Phone (931) 296-0211
Organizations & group practices 15
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.
-
- Emergency Medicine Physician
- Germantown, TN
- NPI 1518747526
-
- Emergency Medicine Physician
- Jackson, TN
- NPI 1538345855
-
- Emergency Medicine Physician
- Memphis, TN
- NPI 1801677083
-
- Emergency Medicine Physician
- Memphis, TN
- NPI 1609657873
-
- Emergency Medicine Physician
- Memphis, TN
- NPI 1023899291
-
- Family Medicine Physician
- Jackson, TN
- NPI 1780686436
-
- Family Nurse Practitioner
- Memphis, TN
- NPI 1174221337
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
- Children's Hospital
- Germantown, TN
- NPI 1649654450
-
- General Acute Care Hospital
- Bartlett, TN
- NPI 1811929151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1306263678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 SKYLINE DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013923",
"telephone_number": "731-541-5000",
"fax_number": "731-410-0367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 SKYLINE DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013923",
"telephone_number": "731-541-5000",
"fax_number": "731-410-0367"
}
],
"practiceLocations": [
{
"address_1": "294 Summar Dr",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "TN",
"postal_code": "383013915",
"country_code": "US",
"telephone_number": "731-423-1932 x323",
"fax_number": "731-410-0367",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYNNE",
"first_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-25",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "MD0000053625",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TN",
"license": "53625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.