Individual provider Active NPI

Wyette W Donovan, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1316183502
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1890 Issued in FL
Practice address
1521 N 14TH Ave
Pensacola, FL 32503-5611
Phone
(850) 470-9300
Fax
(850) 470-9500
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW1890 FL Primary

Addresses

Primary practice location

1521 N 14TH Ave
Pensacola, FL 32503-5611

Mailing address

1521 N 14TH Ave
Pensacola, FL 32503-5611
Phone (850) 470-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000888 FL Practitioner - Clinical Social Worker 7214117076 Practice locations: Pensacola, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1521 N 14TH Ave
Pensacola, FL 32503-5611
Phone (850) 375-5630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1316183502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 N 14TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325035611",
            "telephone_number": "850-470-9300",
            "fax_number": "850-470-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 N 14TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325035611",
            "telephone_number": "850-470-9300",
            "fax_number": "850-470-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "WYETTE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.