Active NPI
Toni Wyatt, LMSW
- Case Management Agency
- Fort Worth, TX
National Provider Identifier
1417413089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 64742
- Practice address
- 6200 Pershing Ave Apt 346
Fort Worth, TX 76116-2618 - Phone
- (214) 686-0023
- NPI assigned
- Feb 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 64742 | TX | Primary |
Addresses
Primary practice location
6200 Pershing Ave Apt 346
Fort Worth, TX 76116-2618
Mailing address
6200 Pershing Ave Apt 346
Fort Worth, TX 76116-2618
Phone (214) 686-0023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64742 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1417413089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 PERSHING AVE APT 346",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761162618",
"telephone_number": "214-686-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 PERSHING AVE APT 346",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761162618",
"telephone_number": "214-686-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "TONI",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "TX",
"license": "64742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.