Alisha Nichol Wyatt, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43080 Issued in TN

Practice address

529 N Gorman St
Forrest City, AR 72335-2736

Phone

(870) 633-9403

NPI assigned

Oct 18, 2007

Last updated

May 30, 2008By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1528257250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 N GORMAN ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352736",
            "telephone_number": "870-633-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 N GORMAN ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352736",
            "telephone_number": "870-633-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "ALISHA",
        "middle_name": "NICHOL",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059978",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "43080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shontel Denise Wilson, MS,CCC-SLP
• Lashunda Winfrey, CM/ACTIVITY THERP.
• Eric R Wood, CRNA
• Tamikak Woodard, CASE MANAGER
• Woodridge of Forrest City, LLC (Perimeter Behavioral of Forrest City)
• Wynne Elder Care LLC
• Nina R Young
• Young's for Transit LLC
• Youngs One Stop Transport LLC

• Internal Medicine Physician in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.