Kenneth James Wysocki, PHD, FNP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN068583 Issued in AZ

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(602) 702-3825

NPI assigned

Feb 7, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

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.

• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1720128069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 E LEWIS AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850082616",
            "telephone_number": "602-702-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "602-702-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PHD, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN068583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Wright, APRN, FNP-C
• Jessica A Wright, LICENSED PSYCHOLOGIS
• Katrenia J Wycough, RN, A/GNP-C
• Larry L Wynia
• Charlotte Casey Wynn, CRNP
• Tiffany Lager Wyttenbach, FNP-C
• Ashely Ka Zoua Xiong, OTR/L
• Erla Abigail Yanes
• Heidi Yang
• John Yang

• Registered Nurse in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.