Individual provider Active NPI

Mygleetus Williams Wright, M.D.

  • Pediatrics Physician
  • Warner Robins, GA
National Provider Identifier
1811983703
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
031196 Issued in GA
Practice address
116 S Houston Rd
Warner Robins, GA 31088-3904
Phone
(478) 751-2580
Fax
(478) 953-6727
NPI assigned
Sep 26, 2005
Last updated
Jan 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 031196 GA Primary

Addresses

Primary practice location

116 S Houston Rd
Warner Robins, GA 31088-3904

Mailing address

116 S Houston Rd
Warner Robins, GA 31088-3904
Phone (478) 923-0131

Other identifiers 1

IdentifierTypeStateIssuer
722335141AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031196GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Care After Hours Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1811983703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883904",
            "telephone_number": "478-923-0131",
            "fax_number": "478-922-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883904",
            "telephone_number": "478-751-2580",
            "fax_number": "478-953-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MYGLEETUS",
        "middle_name": "WILLIAMS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "031196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "722335141A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.