Susan D. Wyrick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9501464 Issued in NC

Practice address

1700 Abbey PL Ste 102
Charlotte, NC 28209-3711

Phone

(704) 522-6656

Fax

(704) 522-6665

NPI assigned

Sep 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 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1316049489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ABBEY PL STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093711",
            "telephone_number": "704-522-6656",
            "fax_number": "704-522-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ABBEY PL STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093711",
            "telephone_number": "704-522-6656",
            "fax_number": "704-522-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYRICK",
        "first_name": "SUSAN",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9501464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8989637",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Thomas Wynn, M.D.
• Sentaria Wynn
• Ashley Kathryn Wynne, MS CCC-SLP
• John Patrick Wynne, MD
• Leigh Ann Wyrick, LCMHCA
• Toni Lee Wyrick, ED.S., PSY.D.
• Ann Wyttenbach, MD
• Rachel Wzorek
• Devin Martie Xayasomloth
• Xcel Transportation and Services, LLC

• Pediatrics Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.