Individual provider Active NPI

William Kendall Wyatt, MD, RN

  • Hospitalist Physician
  • Charleston, WV
National Provider Identifier
1629509013
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
29900 Issued in WV
Practice address
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone
(304) 388-5432
NPI assigned
Mar 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29900 WV
Hospitalist Physician 208M00000X 35.138869 OH
Hospitalist Physician 208M00000X 29900 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200805000797 WV Practitioner - Hospitalist 2961777826 Reassigns benefits to 1 organization
I20260130001060 GA Practitioner - Hospitalist 2961777826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Hospitalist Group, LLCGroup PAC ID 8022272913, 22 clinicians

Practice addresses (Care Compare)

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Registered Nurse

State licenses

LicenseStateTypeSpecialty
29900WVMDLicensed Practical Nurse
35.138869OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Hospitalist Group, LLC CurrentSince Jan 13, 2026 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1629509013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "WILLIAM",
        "middle_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "MD, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29900",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.138869",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "29900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.