DR. JOSEPH O WYATT (NPI# 1871561126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871561126 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH O WYATT |
| Other Name | DR. WYATT JOE WOLLMANN |
| Credential | MD |
| Practice Address |
100 Mac Lane Avera Medical Group Pierre Pierre SD 57501 |
| Practice Telephone | 6059455259 |
| Practice Fax Number | 6059455094 |
| Mailing Telephone | 6059455259 |
| Mailing Fax Number | 6059455094 |
| Enumeration Date | 2006-03-12 |
| Last Update Date | 2012-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 7274 | SD | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 025520 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 7500522 | 05 |
| Street Address |
100 MAC LANE AVERA MEDICAL GROUP PIERRE |
| City | PIERRE |
| State | SD |
| Zip Code | 57501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600276 | Cindy D. Erwin | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2005-06-22 |
| 1609955939 | Medical Associates Clinic Surgery Center | Clinic/Center | 100 Mac Lane, Pierre, SD 57501-0758 | 2006-11-06 |
| 1972618924 | Jeffrey J Liudahl | Otolaryngology | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-08-20 |
| 1568473247 | Vicki Blake-nafus | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-08-10 |
| 1942245071 | Christopher Miller | Nurse Anesthetist, Certified Registered | 100 Mac Lane, Medical Associates LLP, Pierre, SD 57501 | 2006-06-20 |
| 1851335905 | Jon Vander Maten | Physician Assistant | 100 Mac Lane, Pierre, SD 57501-0758 | 2006-06-16 |
| 1124062823 | Darcy J Mcclelland | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-15 |
| 1518900125 | Medical Associates Clinic LLP | Clinic/Center | 100 Mac Lane, Pierre, SD 57501 | 2006-06-13 |
| 1659314367 | Barb J Joy | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-13 |
| 1972546596 | Jayne L Novotny | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518420694 | Shawna K Fullerton | Social Worker | 1309 E Wells Ave, Pierre, SD 57501 | 2019-04-07 |
| 1841779758 | Joanne Sarringar | Physical Therapist | 801 E. Sioux Avenue, Pierre, SD 57501 | 2018-08-10 |
| 1003234832 | Katherine Bonnichsen | Dermatology | Avera Medical Group Pierre - Helmsley Center, 801 E Sioux Ave, Pierre, SD 57501 | 2014-03-29 |
| 1417232166 | Louis J Van Roekel | Pharmacist | 100 E Sioux, Pierre, SD 57501 | 2011-10-13 |
| 1508164401 | Bechtold Thompson Dental Clinic | Dentist | 640 E. Sioux Ave, Pierre, SD 57501 | 2011-03-02 |
| 1417180969 | Dentistry At The St. Charles LLC | Dentist | 207 E. Capitol Ave. Ste 201, Pierre, SD 57501 | 2009-09-01 |
| 1063663995 | Buron O. Lindbloom | Family Medicine | 3200 E. Hwy 34, S.d. Womens Prison, Pierre, SD 57501 | 2008-10-09 |
| 1831221522 | Curt C Kuehl | Chiropractor | 430 W Sioux Ave, Pierre, SD 57501 | 2007-03-09 |
| 1376603092 | Tim Wald | Physical Therapist | 1012 Woodview Dr #20, Pierre, SD 57501 | 2006-12-11 |
| 1184702540 | Tami Lynn Hogie-lorenzen | Nurse Practitioner | 1714 Abbey Road, Pierre, SD 57501 | 2006-11-02 |
| Find all providers in zip 57501 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508284506 | Timothy Vanadurongvan | Urology | 715 Ballard Ct, Vermillion, SD 57069-7029 | 2014-04-07 |
| 1851654768 | Carlton Kom | Urology | 215 9th Ave Se, Aberdeen, SD 57401-6161 | 2012-06-18 |
| 1053583468 | Alexander Murray Mcbride | Urology | 945 Country Club Dr, Spearfish, SD 57783-3102 | 2008-03-25 |
| 1477740942 | Dakota Urology Clinic PC | Urology | 2200 North Kimball Street, Suite 900, Mitchell, SD 57301 | 2007-09-28 |
| 1275654782 | Eugene S Park | Urology | 201 W 69th Street, Sioux Falls, SD 57108-2424 | 2007-04-02 |
| 1518006931 | Larry Alan Meyer | Urology | 2602 Mulberry St, Yankton, SD 57078-4854 | 2007-02-05 |
| 1528130085 | Dileep S Bhat | Urology | 2200 North Kimball, Suite 900, Mitchell, SD 57301 | 2006-11-13 |
| 1588754626 | Rama K.t Varma | Urology | Veterans Administration Medical Center - Fort Meade, 113 Comanche Rd, Fort Meade, SD 57741 | 2006-10-12 |
| 1871687442 | Christine Lynne Bradbury | Urology | 500 North 5th Street, Hot Springs, SD 57747 | 2006-10-03 |
| 1306943576 | Xenofon Papadopoulos | Urology | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2006-09-20 |
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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.