Individual provider Active NPI

Charles Handfield Wyatt, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Mobile, AL
National Provider Identifier
1740287630
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD41701 Issued in AL
Practice address
3715 Dauphin St Ste 7a
Mobile, AL 36608-1775
Phone
(251) 410-4001
Fax
(251) 410-4002
NPI assigned
Jul 7, 2005
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD41701 AL Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME64289 FL

Addresses

Primary practice location

3715 Dauphin St Ste 7a
Mobile, AL 36608-1775

Mailing address

PO Box 11407 Dept # 8094
Birmingham, AL 35246-0001
Phone (251) 410-4002

Other practice location 1

5147 N 9th Ave Ste 318
Pensacola, FL 32504-8710
Phone (850) 462-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210721000634 AL Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 7012913965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Vascular Surgery
Education
Baylor College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3715 Dauphin St
Suite 7a
Mobile, AL 36608-1775
Phone (251) 410-4001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD41701ALMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springhill Physician Practices, Inc CurrentSince Sep 1, 2021 Accepting new patients
Springhill Physician Practices, Inc CurrentSince Sep 1, 2021 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Springhill Physician Practices, Inc. Past Accepting new patients
Cardiovascular Institute of the South, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

1000A Cody Rd S
Mobile, AL 36695
Phone (251) 340-7942

3632 Dauphin St
Ste 101B
Mobile, AL 36608
Phone (251) 460-5280

3715 Dauphin St
Ste 7A
Mobile, AL 36608
Phone (251) 410-4001

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

Interoperability endpoints

  • Direct secure messaging: cwyatt@springhillphy.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73098

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1740287630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT # 8094",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460001",
            "telephone_number": "251-410-4002",
            "fax_number": "251-410-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 DAUPHIN ST STE 7A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081775",
            "telephone_number": "251-410-4001",
            "fax_number": "251-410-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5147 N 9th Ave Ste 318",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048710",
            "country_code": "US",
            "telephone_number": "850-462-2250",
            "fax_number": "850-741-3053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CHARLES",
        "middle_name": "HANDFIELD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AL",
            "license": "MD41701",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME64289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.