Jordan Cage Wyatt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

328850 Issued in LA

Practice address

2449 Hospital Dr Ste 300
Bossier City, LA 71111-1910

Phone

(318) 212-7960

Fax

(318) 212-7965

NPI assigned

Sep 28, 2021

Last updated

Feb 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Spine and Pain SpecialistsGroup PAC ID 0547569840, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jwyatt@direct.wkhs.com

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.

• WK Spine & Pain Specialists

  • Interventional Pain Medicine Physician
  • Bossier City, LA
  • NPI 1982065645
  Medicare reassignment Care Compare group
• WK Pediatric Surgical Associates

  • Pediatric Surgery Physician
  • Shreveport, LA
  • NPI 1316386436
  Medicare reassignment
• WK River Cities Interventional Pain

  • Pain Medicine (Anesthesiology) Physician
  • Shreveport, LA
  • NPI 1962447052
  NPD (past)

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1699447615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 300",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111910",
            "telephone_number": "318-212-7960",
            "fax_number": "318-212-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 300",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111910",
            "telephone_number": "318-212-7960",
            "fax_number": "318-212-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "JORDAN",
        "middle_name": "CAGE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "328850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaka Wright
• Christopher Wright
• Wunnenberg Enterprises LLC (Greenacres Chiropractic)
• Steven Kyle Wunnenberg, D.C.
• Donna Lynn Wyatt, MD
• Naomi Wyatt
• Stacy Wyatt, RPH
• Y K Reddy MD Apmc Asthma and Allergy Center
• Michael Adrian Yang, PHARMD, RPH
• Yellow Med Logistics LLC

• Physician Assistant in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.
• 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.