Wynne Kendra Lott, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003905 Issued in GA

Practice address

4 S Tallahassee St Ste 4
Hazlehurst, GA 31539-6136

Phone

(912) 699-6570

Fax

(912) 699-6572

NPI assigned

Jan 23, 2007

Last updated

Sep 25, 2023By 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 GA

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

Medical College of Georgia School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahmed Elsharkawi MD LLCGroup PAC ID 4385781467, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wynne.lott.1@22730.direct.athenahealth.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.

• Ahmed Elsharkawi MD LLC

  • Nephrology Physician
  • Brunswick, GA
  • NPI 1184856494
  Medicare reassignment Care Compare group
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1255930228

  GA

  Medicare reassignment NPD
• Harrison C Carter MD PC

  • Specialist
  • Alma, GA
  • NPI 1619174091
  Medicare reassignment
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Hospital

  • Critical Access Hospital
  • Hazlehurst, GA
  • NPI 1912902263
  Medicare reassignment
• Montgomery Emergency Group, LLC

  • Emergency Medicine Physician
  • Vidalia, GA
  • NPI 1861773764
  Medicare reassignment
• Wayne Emergency Group LLC

  • Emergency Medicine Physician
  • Jesup, GA
  • NPI 1982828943
  Medicare reassignment
• Consultants in Pain Medicine, LLC

  dba Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Brunswick, GA
  • NPI 1902852130
  NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Family Healthcare Connections

  • Internal Medicine Physician
  • Hazlehurst, GA
  • NPI 1528874518
  NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Family Medical Group

  • Rural Health Clinic/Center
  • Hazlehurst, GA
  • NPI 1912379082
  NPD
• Marshes Medical Diagnostic Clinic, PC

  • Nephrology Physician
  • Brunswick, GA
  • NPI 1013922699
  NPD
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• McRae Emergency Services, LLC

  • Nurse Practitioner
  • McRae, GA
  • NPI 1467480400

  Medical

  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1811042815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S TALLAHASSEE ST STE 4",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396136",
            "telephone_number": "912-699-6570",
            "fax_number": "912-354-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S TALLAHASSEE ST STE 4",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396136",
            "telephone_number": "912-699-6570",
            "fax_number": "912-699-6572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 Shrine Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315204787",
            "country_code": "US",
            "telephone_number": "912-264-6133",
            "fax_number": "912-267-1415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314045502",
            "country_code": "US",
            "telephone_number": "912-354-4813",
            "fax_number": "912-354-7569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314045502",
            "country_code": "US",
            "telephone_number": "912-354-4813",
            "fax_number": "912-354-7569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOTT",
        "first_name": "WYNNE",
        "middle_name": "KENDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Hospice of South Ga, LLC (Coastal Hospice of Georgia)
• Alexis Leggett, PHARM D
• Kaylynn Leggett
• Jade Denice Lott
• Virginia Barnwell Lott
• Vijay K. Mahathre, M.D.
• Candace Lynn Martinez
• Michael Lloyd Mason, OD
• Johanna McDowell, SLP-CF
• Landyn Miller, PHARMD, RPH

• Medical Physician Assistant in Hazlehurst, GA
• Providers in Hazlehurst, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.