Carolyn Wyatt, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0032932 Issued in MD

Practice address

8808 Centre Park Dr
Suite 206
Columbia, MD 21045-2126

Phone

(410) 884-6116

Fax

(410) 730-1803

NPI assigned

May 16, 2006

Sex

Female

Sole proprietor

Yes

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 MD

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

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1316999840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 CENTRE PARK DRIVE",
            "address_2": "SUITE 206",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "410-884-6116",
            "fax_number": "410-730-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8808 CENTRE PARK DR",
            "address_2": "SUITE 206",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452126",
            "telephone_number": "410-884-6116",
            "fax_number": "410-730-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CAROLYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0032932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597771103",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Wu
• Eric J Wu, DDS
• Kenneth Jingen Wu, D.D.S.
• Vicki Wuest, MS, CNS, LDN
• Eyako Kofi Wurapa, MD
• Kathleen Margaret Wygal, OTR/L
• Amy Wyndham
• Wynn Kao Dermatology, LLC
• Samantha Wynn, OTR/L
• Crystal Wyser, BCBA

• Family Medicine Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.