Individual provider Active NPI

Emily J Wyatt, PMHNP BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1912197674
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APO 5212 Issued in LA
Practice address
234 Rue Beauregard
Suite 100
Lafayette, LA 70508-3285
Phone
(337) 593-0830
Fax
(337) 593-0122
NPI assigned
Jul 30, 2007
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APO 5212 LA Primary

Addresses

Primary practice location

234 Rue Beauregard
Suite 100
Lafayette, LA 70508-3285

Mailing address

234 Rue Beauregard
Suite 100
Lafayette, LA 70508-3285
Phone (337) 593-0830

Other identifiers 1

IdentifierTypeStateIssuer
APO 5212OtherLALOUISIANA STATE BOARD OF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20071120000171 LA Practitioner - Nurse Practitioner 9638267974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1602 W Pinhook Rd
100A
Lafayette, LA 70508-3735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APO 5212LAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bob Winston MD PSC CurrentSince Aug 1, 2007 Accepting new patients
Solutions Recovery, LLC Past Accepting new patients

Locations

810 S Broadway St
Church Point, LA 70525
Phone (337) 684-4281

2020 W Pinhook Rd
Ste 504
Lafayette, LA 70508
Phone (337) 214-2100

234 Rue Beauregard
Ste 100
Lafayette, LA 70508
Phone (337) 593-0830

Organizations & group practices 2

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1912197674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 RUE BEAUREGARD",
            "address_2": "SUITE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083285",
            "telephone_number": "337-593-0830",
            "fax_number": "337-593-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 RUE BEAUREGARD",
            "address_2": "SUITE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083285",
            "telephone_number": "337-593-0830",
            "fax_number": "337-593-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "EMILY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PMHNP BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "APO 5212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE BOARD OF",
            "identifier": "APO 5212",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.