Individual provider Active NPI

Susan T Wingo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Amarillo, TX
National Provider Identifier
1457397697
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
L6722 Issued in TX
Practice address
1301 S Coulter St
Suite 106
Amarillo, TX 79106-1763
Phone
(806) 350-7307
Fax
(806) 677-2024
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X L6722 TX Primary

Addresses

Primary practice location

1301 S Coulter St
Suite 106
Amarillo, TX 79106-1763

Mailing address

1215 S Coulter St Ste 400
Amarillo, TX 79106-1769
Phone (806) 350-7307

Other identifiers 1

IdentifierTypeStateIssuer
163988202MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1457397697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST STE 400",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061769",
            "telephone_number": "806-350-7307",
            "fax_number": "806-677-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S COULTER ST",
            "address_2": "SUITE 106",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061763",
            "telephone_number": "806-350-7307",
            "fax_number": "806-677-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGO",
        "first_name": "SUSAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "L6722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163988202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.