Kenneth N Wycoff, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.14738 Issued in OH

Practice address

733 Market Ave S
Canton, OH 44702-2165

Phone

(330) 489-4600

Fax

(216) 229-2642

NPI assigned

Jul 25, 2013

Last updated

Jan 29, 2020By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kennethwycoff@cancc.allscriptsdirect.net

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1700228269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "330-489-4600",
            "fax_number": "216-229-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 MARKET AVE S",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447022165",
            "telephone_number": "330-489-4600",
            "fax_number": "216-229-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCOFF",
        "first_name": "KENNETH",
        "middle_name": "N",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.14738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088611",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krysta N Wuertz, LPC
• Chris Wurst
• Teresa Lynn Wurst, MD
• Mary Wyant, LSW
• Naomi A Wychanko, M.D.
• Lori Wyler, APRN-C
• Cailynn Wynn, LPC
• Richard E Wyszynski, M.D.
• Zuoliang Xiao, M.D.
• XL Developmental Services, Inc.

• Family Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.