Carrie Jo Wynn, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F306137-1 Issued in NY

Practice address

9 Reservoir Rd.
Pawling, NY 12564-6401

Phone

(845) 855-5700

NPI assigned

Jul 28, 2013

Last updated

Jun 25, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

Practice roles

Locations

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.

• Mill Basin Medical Health PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346006202
  Medicare reassignment NPD
• Nys Medical Associate PLLC

  • Internal Medicine Physician
  • Rego Park, NY
  • NPI 1104268572
  Medicare reassignment NPD

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

{
    "created_epoch": "1374969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1437591757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RESERVOIR RD.",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "12564",
            "telephone_number": "845-855-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RESERVOIR RD.",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "125646401",
            "telephone_number": "845-855-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "CARRIE",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-28",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306137-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah C Velez
• Village Medical PLLC
• Elizabeth Weiss, PT, FOC
• Karen L. Wolf, CCC-SLP
• Marcia Jennifer Wood, LPN
• Brett Lauren Zuckerman, CCC-SLP

• Adult Health Nurse Practitioner in Pawling, NY
• Providers in Pawling, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.