Carol Ann Wynn, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704234489 Issued in MI

Practice address

27351 Dequindre Rd
Madison Heights, MI 48071-3487

Phone

(248) 967-7655

NPI assigned

Nov 1, 2011

Last updated

Nov 1, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwynn1158270@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1346526662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4983 JUNIPER DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483821545",
            "telephone_number": "313-402-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "248-967-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704234489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodward Detroit CVS LLC (CVS Pharmacy #16089)
• Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08033)
• Wright & Filippis, LLC
• Wright & Filippis, LLC
• Wright Transportation Services, LLC
• Isabella Yaldo
• Jasmine Yancey
• Rita Youkhana, PA-C
• Jasper Yung, D.O.
• Morgan Olivia Zach, RDN

• Adult Health Nurse Practitioner in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.