Kristin Wyatt, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

103181 Issued in NC

Practice address

2213 Elba St
RM 115
Durham, NC 27705-3934

Phone

(919) 684-6182

NPI assigned

Mar 8, 2017

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Arise Psychological Wellness and Consulting, PLLC

  • Psychologist
  • Chapel Hill, NC
  • NPI 1093382574
  NPD Authorized official

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1932649019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DUMC BOX 3026",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-684-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 ELBA ST",
            "address_2": "RM 115",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053934",
            "telephone_number": "919-684-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "KRISTIN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "103181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manoj Bobby Subbarao Wunnava, M.D.
• Brian Wurzinger, DPT, ATC
• Karen Whitney Wurzinger, OTR/L
• Danielle Adriana Dupont Wyant, M.D.
• Shannon Jo Wyatt-Nyquist, OTD, OTR/L
• John D Wylie, M.D., PH.D.
• Kristin Vernice Wylie, MSPT
• Kimberly Michelle Wyman, NP
• Andrew Wynkoop
• Leigh Wynkoop, PA-C

• Clinical Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.