Individual provider Active NPI

Wynn Traylor Harvey, D.C.

  • Chiropractor
  • Pineville, LA
National Provider Identifier
1649204736
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
908 Issued in LA
Practice address
1319 Donahue Ferry Rd
Pineville, LA 71360-5143
Phone
(318) 443-7232
Fax
(318) 443-5881
NPI assigned
Jul 11, 2006
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 908 LA Primary

Addresses

Primary practice location

1319 Donahue Ferry Rd
Pineville, LA 71360-5143

Mailing address

1319 Donahue Ferry Rd
Pineville, LA 71360-5143
Phone (318) 443-7232

Other identifiers 1

IdentifierTypeStateIssuer
2919AOtherLABLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110207000674 LA Practitioner - Chiropractic 6901086008 Practice locations: Pineville, LA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1319 Donahue Ferry Rd
Pineville, LA 71360-5143
Phone (318) 443-7232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
908LAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1649204736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 DONAHUE FERRY RD",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605143",
            "telephone_number": "318-443-7232",
            "fax_number": "318-443-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 DONAHUE FERRY RD",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605143",
            "telephone_number": "318-443-7232",
            "fax_number": "318-443-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "WYNN",
        "middle_name": "TRAYLOR",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "2919A",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.