MS. BROOKE MARY WYATT (NPI# 1821286519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821286519 |
| Entity Type | Individual |
| Full Name | MS. BROOKE MARY WYATT |
| Credential | PA |
| Practice Address |
1645 S Main St Suite 101 Crossville TN 38555-2908 |
| Practice Telephone | 9314847531 |
| Practice Fax Number | 9314569515 |
| Mailing Telephone | 9314847531 |
| Mailing Fax Number | 9314569515 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2014-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1544 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1512162 | 05 | |
| TN | BCBS | 4224896 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972915031 | Brooke Wyatt | Speech-Language Pathologist | 1123 Chestnut Dr, Frisco, TX 75034-3932 | 2014-05-23 |
| 1720355852 | Brooke Wyatt | Physical Therapist | 3550 Alameda De Las Pulgas, Menlo Park, CA 94025-6559 | 2011-11-17 |
| Street Address |
1645 S MAIN ST SUITE 101 |
| City | CROSSVILLE |
| State | TN |
| Zip Code | 38555-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295734382 | Thomas E Clayton | Internal Medicine | 1645 S Main St, Suite 101, Crossville, TN 38555-5998 | 2005-07-20 |
| 1942441332 | Physicians' Associates, LLC | General Practice | 1645 S Main St, Suite 101, Crossville, TN 38555-2908 | 2009-03-13 |
| 1851426621 | Luisa T Manestar | Family Medicine | 1645 S Main St, Suite 101, Crossville, TN 38555-2908 | 2007-02-22 |
| 1467544148 | Richard Matthew Buurman | Family Medicine | 1645 S Main St, Suite 101, Crossville, TN 38555-2908 | 2006-09-29 |
| 1275548877 | United Apothecary Inc | Pharmacy | 1645 S Main St, Ste 102, Crossville, TN 38555-2908 | 2006-07-30 |
| 1174522049 | Kimberly S Peaslee | Internal Medicine | 1645 S Main St, Suite 101, Crossville, TN 38555-5998 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679106306 | North Main Medical, LLC | Family Medicine | 3094 N Mainst, Crossville, TN 38555 | 2020-02-21 |
| 1013566991 | Arehart Enterprises Plc | Anesthesiology | 181 Matherly Street, Crossville, TN 38555 | 2019-09-04 |
| 1194220236 | William Stacy Swafford | Pain Medicine | 181 Matherly St, Crossville, TN 38555 | 2018-03-29 |
| 1871024539 | Adam Hill | Nurse Practitioner | 229 Interstate Dr Ste 103, Crossville, TN 38555 | 2017-03-24 |
| 1568862639 | Happy Hearts Home Care LLC | Home Health | 61 Birchwood Lane, Crossville, TN 38555 | 2014-08-26 |
| 1891072187 | Quality Medical Center, PC | Clinic/Center | 15 Walker Hill Cir, Crossville, TN 38555 | 2011-11-15 |
| 1306137393 | Beatrice L. Durham | Family Medicine | 421 South Main St., Crossville, TN 38555 | 2011-04-25 |
| 1881901353 | Donna Laughter | Licensed Practical Nurse | 1503 South Main St., Crossville, TN 38555 | 2010-09-07 |
| 1922311083 | Carl Thomas Duer Sr. | General Practice | 840 Holiday Dr, Crossville, TN 38555 | 2010-07-19 |
| 1295048445 | Michael Lee Hamby | Pharmacist | 85 Elmore Ave, Crossville, TN 38555 | 2010-07-16 |
| Find all providers in zip 38555 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720076102 | Charles Steven Clifton | Physician Assistant | 396 S Main St, Crossville, TN 38555-5092 | 2005-10-11 |
| 1548599608 | Chadrick Leon Hull | Physician Assistant | 131 S Webb Ave, Crossville, TN 38555-8495 | 2009-12-18 |
| 1427069749 | Johnny Wayne Presley | Physician Assistant | 131 S Webb Ave, Crossville, TN 38555-8452 | 2006-08-11 |
| 1629089065 | Beverly Joan Gardner | Physician Assistant | 131 S Webb Ave, Crossville, TN 38555-8452 | 2006-08-10 |
| 1457325755 | Shawn James Brunelle | Physician Assistant | 421 S Main St, Crossville, TN 38555-5048 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840972 | Alexis Sierra Foster | Physician Assistant | 953 Prince Ave, Erwin, TN 37650-1445 | 2020-11-01 |
| 1972110831 | Marleen Yosef | Physician Assistant | 6 Whitsett Rd, Nashville, TN 37210-5345 | 2020-09-24 |
| 1538772744 | Kaitlyn Blair Barger | Physician Assistant | 2100 Clinch Ave Ste 120, Knoxville, TN 37916-2288 | 2020-08-26 |
| 1225653967 | Molly Ann Waggoner | Physician Assistant | 9050 Executive Park Dr Ste 100b, Knoxville, TN 37923-4616 | 2020-06-09 |
| 1134749922 | Mckenzie Jacobson | Physician Assistant | 302 Tyson Ave # B, Paris, TN 38242-4576 | 2020-04-21 |
| 1316580913 | Donald Jacob Calella | Physician Assistant | 8146 Propeller Dr, Ooltewah, TN 37363-9561 | 2019-10-26 |
| 1811458565 | Physician Associate Resources, Plc | Physician Assistant | 1559 Highland Park Drive, Lenoir City, TN 37772 | 2019-03-26 |
| 1336617059 | Micaela L Goebel | Physician Assistant | 120 Tanner Pl Bldg H, Clinton, TN 37716-6684 | 2018-11-12 |
| 1700369162 | Lauren Peyton Hunley | Physician Assistant | 6890 W Andrew Johnson Hwy, Talbott, TN 37877-8610 | 2018-09-12 |
| 1275039471 | Jessica Taylor Epting | Physician Assistant | 107 Glen Oak Blvd Ste 200, Hendersonville, TN 37075-3162 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
| City | CROSSVILLE |
| Zip Code | 38555 |
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| 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.