MRS. KATHERINE D WYATT (NPI# 1467413393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467413393 |
| Entity Type | Individual |
| Full Name | MRS. KATHERINE D WYATT |
| Credential | LPC |
| Practice Address |
240 Broad St Kernersville NC 27284-2930 |
| Practice Telephone | 3369938333 |
| Mailing Telephone | 3369938333 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2015-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
4900 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | CIGNA | 2268491 | 01 |
| NC | 6102822 | 05 | |
| NC | MAGELLAN | 831160000 | 01 |
| NC | BC | 1400F | 01 |
| NC | TRICARE | 204836896 | 01 |
| NC | MEDCOST | 194339 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003273814 | Katherine E Wyatt | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2016-01-25 |
| Street Address |
240 BROAD ST |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-2930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982682183 | Michael E. Albright | Pediatrics | 240 Broad St, Kernersville, NC 27284-2930 | 2006-01-06 |
| 1215420658 | Caroline Cloud Jones | Physician Assistant | 240 Broad St, Kernersville, NC 27284 | 2018-06-11 |
| 1770909699 | Jamila Palmer | Nurse Practitioner | 240 Broad St, Kernersville, NC 27284-2930 | 2014-03-17 |
| 1184939241 | Forsyth Medical Group, LLC | Pediatrics | 240 Broad St, Kernersville, NC 27284-2930 | 2010-08-13 |
| 1629002910 | Vanessa K Ajizian | Pediatrics | 240 Broad St, Kernersville, NC 27284-2930 | 2006-07-10 |
| 1679506539 | Sabrina Michelle Lachowicz | Physician Assistant | 240 Broad St, Kernersville, NC 27284-2930 | 2006-07-07 |
| 1114985017 | Forsyth Medical Group LLC | Physician Assistant | 240 Broad St, Kernersville, NC 27284-2930 | 2006-05-02 |
| 1306808084 | George Kirk Walker | Pediatrics | 240 Broad St, Kernersville, NC 27284-2930 | 2006-04-06 |
| 1730149824 | Bill A Ricketts | Physician Assistant | 240 Broad St, Kernersville, NC 27284-2930 | 2006-03-24 |
| 1679532212 | Tammy Griffin Shimfessel | Nurse Practitioner | 240 Broad St, Dba Forsyth Pediatrics Assoicates - K'ville, Kernersville, NC 27284-2930 | 2006-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497352413 | Erin Langley Callan | Counselor | 490 Raven Ridge Rd, Kernersville, NC 27284-8046 | 2020-10-02 |
| 1710462262 | Mind Renewal LLC | Counselor | 1613 Round Hill Cir, Kernersville, NC 27284-7929 | 2018-10-01 |
| 1689165144 | Kenya Wynn | Counselor | 418b W Mountain St Ste B, Kernersville, NC 27284-2534 | 2018-05-21 |
| 1467893958 | Laura Brotherton | Counselor | 144 N Cherry St, Kernersville, NC 27284-2898 | 2013-07-11 |
| 1679888390 | Deisha C Angel | Counselor | 233 W Mountain St, Suite 205, Kernersville, NC 27284-2529 | 2010-08-18 |
| 1588890131 | Weomie Smith | Counselor | 5088 Oak Garden Dr, Kernersville, NC 27284-9593 | 2009-06-09 |
| 1578616744 | Lori Jean Wainright | Counselor | 110 Harmon Ln Ste B, Kernersville, NC 27284-3474 | 2007-01-19 |
| 1841355930 | Youth Opportunities | Counselor | 110 Brown Road, Kernersville, NC 27284-2305 | 2006-12-27 |
| 1891742391 | Kathleen Lou Thach | Counselor | 918 Lake Dr, Kernersville, NC 27284-2238 | 2006-05-28 |
| 1891309365 | Emily Barber | Counselor | 210 N Main St, Kernersville, NC 27284-4004 | 2020-09-02 |
| Find all providers in KERNERSVILLE | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
Please comment or provide details below to improve the information on MRS. KATHERINE D WYATT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.