Wyatt Checketts

Primary specialty

DentistTaxonomy code 122300000X

License

30949 Issued in TX

Practice address

408 Wynn Dr
Jacksonville, TX 75766-4976

Phone

(903) 586-6829

Fax

(903) 589-3728

NPI assigned

Apr 19, 2015

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hatchett and Thompson DDS

  • General Practice Dentistry
  • Jacksonville, TX
  • NPI 1487023727
  NPD (past)
• J.Michael Hatchett, DDS, PC Mark Allan Thompson, DDS, PC

  • Dentist
  • Jacksonville, TX
  • NPI 1679855852
  NPD (past)

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

{
    "created_epoch": "1429401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1477940351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WYNN DR",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664976",
            "telephone_number": "208-201-4148",
            "fax_number": "903-589-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 WYNN DR",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664976",
            "telephone_number": "903-586-6829",
            "fax_number": "903-589-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHECKETTS",
        "first_name": "WYATT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-19",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30949",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda Joyce Casteel
• Center Care Clinic PLLC.
• Anup Chabra
• Charles Burk
• Nirmala Nandini Cheatham, M.D.
• Cherokee County (Cherokee County Health Department)
• Cherokee County
• Cherokee Emergency Medicine Associates PA
• Crystal Christopher
• City of Jacksonville (Jacksonville Fire Department)

• Dentist in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.