Shannon Jo Wyatt-Nyquist, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12723 Issued in NC

Practice address

3609 SW Durham Dr
Durham, NC 27707-6507

Phone

(919) 613-5002

NPI assigned

Aug 30, 2019

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 NC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duke University Health System, IncGroup PAC ID 2567372345, shared by 22 NPIs, 1,083 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Duke University Health System, Inc.

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1376574798
  Medicare reassignment NPD
• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment NPD
• Duke University Health System, Inc.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1336448810
  NPD
• Duke University Health System, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1962050161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 SW DURHAM DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076507",
            "telephone_number": "919-613-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 SW DURHAM DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076507",
            "telephone_number": "919-613-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT-NYQUIST",
        "first_name": "SHANNON",
        "middle_name": "JO",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "12723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheue-Mei Wu, MD
• Manoj Bobby Subbarao Wunnava, M.D.
• Brian Wurzinger, DPT, ATC
• Karen Whitney Wurzinger, OTR/L
• Danielle Adriana Dupont Wyant, M.D.
• Kristin Wyatt, PH.D.
• John D Wylie, M.D., PH.D.
• Kristin Vernice Wylie, MSPT
• Kimberly Michelle Wyman, NP
• Andrew Wynkoop

• Occupational Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.