Individual provider Active NPI

Cheryl Wyatt

  • Nurse Practitioner
  • California, MD
National Provider Identifier
1932129574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R131556 Issued in MD
Practice address
22576 Macarthur Blvd
California, MD 20619-3086
Phone
(301) 737-0500
Fax
(301) 737-3351
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R131556 MD Primary

Addresses

Primary practice location

22576 Macarthur Blvd
California, MD 20619-3086

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080801000403 MD Practitioner - Nurse Practitioner 4880768233 Reassigns benefits to 2 organizations
I20170428000603 DC Practitioner - Nurse Practitioner 4880768233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

3064 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 932-5960

37767 Market Dr
Charlotte Hall, MD 20622-3188
Phone (301) 290-1499

45870 E Run Dr
Lexington Park, MD 20653-4362
Phone (240) 895-8630

500 Charles St
La Plata, MD 20646-5931
Phone (410) 451-1800

6317 York Rd
Baltimore, MD 21212-2310
Phone (443) 777-6890

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC CurrentSince Jul 1, 2008 Accepting new patients
Medstar Urgent Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Medstar Urgent Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Sep 1, 2021 Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
Heart Center of Southern Maryland, L.L.P. Past Accepting new patients
Shah Associates MD LLC Past Accepting new patients
Shah Associates MD LLC Past Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 425-0000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932129574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22576 MACARTHUR BLVD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193086",
            "telephone_number": "301-737-0500",
            "fax_number": "301-737-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CHERYL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R131556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

Verify at the official NPI Registry.