DR. ROBERT J WYATT (NPI# 1912965070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912965070 |
| Entity Type | Individual |
| Full Name | DR. ROBERT J WYATT |
| Credential | MD |
| Practice Address |
1910 Nonconnah Blvd Suite 120 Memphis TN 38132-2113 |
| Mailing Address |
66 N Pauline St Suite 206 Memphis TN 38105-5105 |
| Practice Telephone | 9014482300 |
| Practice Fax Number | 9014486657 |
| Mailing Telephone | 9014487642 |
| Mailing Fax Number | 9014488015 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-03-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
15403 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3010536 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1922240019 | Robert E. Wyatt | Podiatrist | 9134 Bradenton Rd, Fort Wayne, IN 46835-8892 | 2009-04-03 |
| 1629676119 | Robert J. Wyatt | Registered Nurse | 1700 Airport Way S, Seattle, WA 98134-1618 | 2020-10-15 |
| 1093951915 | Robert K Wyatt | Social Worker | 950 W Ironwood Dr, Suite #2, Coeur D Alene, ID 83814-2644 | 2008-12-23 |
| 1467627398 | Robert A Wyatt | Pharmacist | 2300 Baltimore Reynoldsburg Rd, Reynoldsburg, OH 43068-8030 | 2008-04-22 |
| 1568518694 | Robert Clyde Wyatt | Nurse Anesthetist, Certified Registered | 2801 Medical Center Dr, Pocahontas, AR 72455-9436 | 2007-01-25 |
| Street Address |
1910 NONCONNAH BLVD SUITE 120 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38132-2113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417933276 | Cynthia Denise Cross | Emergency Medicine | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2005-12-22 |
| 1265719496 | Tamara Devon Jones | Social Worker | 1910 Nonconnah Blvd, Suite #100, Memphis, TN 38132-2113 | 2011-11-16 |
| 1417244765 | Compass Laboratory Services LLC | Clinical Medical Laboratory | 1910 Nonconnah Blvd, 108, Memphis, TN 38132-2113 | 2011-07-07 |
| 1508090986 | Oana Maria Hendea | Audiologist | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2009-05-13 |
| 1649429119 | Dawna J. Willis | Nurse Practitioner | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2008-09-09 |
| 1538315304 | Samir Hasmukh Shah | Pediatrics | 1910 Nonconnah Blvd, Ste 120, Memphis, TN 38132-2113 | 2008-08-13 |
| 1710163373 | Martha Katheryn Ballard | Nurse Practitioner | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2008-01-14 |
| 1861673816 | Keith A. Collins | Nurse Anesthetist, Certified Registered | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2007-11-19 |
| 1851510978 | Mindy A Mullins | Nurse Anesthetist, Certified Registered | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2007-04-25 |
| 1275629396 | Sabrina Burns Kuster | Pediatrics | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2006-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386163707 | Casey Provo | Dietitian, Registered | 1689 Nonconnah Blvd., Memphis, TN 38132 | 2017-09-18 |
| 1164802195 | Cynthia Luaune Poole | Social Worker | 2606 Corporate Dr, Memphis, TN 38132 | 2015-06-04 |
| 1033375753 | Concentra Health Services, Inc. | Clinic/Center | 2831 Airways Blvd., Bldg. A, Suite 102, Memphis, TN 38132 | 2008-08-01 |
| 1063406676 | The Synergy Foundation, Inc. | Substance Abuse Rehabilitation Facility | 2305 Airport Interchange Avenue, Memphis, TN 38132 | 2005-09-09 |
| 1932488129 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 2831 Airways Blvd, Bldg A, Ste 102, Memphis, TN 38132 | 2011-08-05 |
| 1699181461 | Stacy Triplett | Counselor | 2305 Airport Interchange Ave, Memphis, TN 38132-1002 | 2014-07-01 |
| 1174852164 | Delois Roberson | Dentist | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2009-12-22 |
| 1801380985 | Javier Jackson | Physical Therapist | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2018-06-21 |
| 1326499252 | Joshua Mock | Physical Therapy Assistant | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2016-06-22 |
| 1295112720 | Michelle Frulla | Physical Therapy Assistant | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2015-05-05 |
| Find all providers in zip 38132 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265500888 | John J Bissler | Pediatrics | 51 N Dunlap St., Ste. 400, Memphis, TN 38105 | 2006-12-01 |
| 1235545849 | Yonique Petrece Petgrave | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2014-07-02 |
| 1386925634 | Arwa Nada | Pediatrics | 51 N Dunlap St, Ste. 400, Memphis, TN 38105 | 2011-08-31 |
| 1841503059 | Rima S. Zahr | Pediatrics | 51 N Dunlap St, Ste. L400, Memphis, TN 38105-4625 | 2010-07-16 |
| 1679746119 | James Gilbert Atherton | Pediatrics | 51 N Dunlap St, Ste. 400, Memphis, TN 38105 | 2008-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942384060 | Valentina Kon | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-10-25 |
| 1902993009 | Kathy Jabs | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-10-09 |
| 1508958919 | Tracy E Hunley | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-09-30 |
| 1902838592 | Rene G Vandevoorde IIi | Pediatrics | 3601 The Vanderbilt Clinic, Nashville, TN 37232-5100 | 2006-07-06 |
| 1659308187 | Billy S Arant Jr. | Pediatrics | 979 East Third Street, Suite B-601, Chattanooga, TN 37403-3316 | 2006-06-28 |
| 1003874165 | Deborah P Jones | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-05-01 |
| 1245297795 | Maricarmen Malagon-rogers | Pediatrics | 1924 Alcoa Hwy, U-115, Knoxville, TN 37920-1511 | 2006-04-27 |
| 1205892353 | Bettina Ault | Pediatrics | 900 E 3rd St, Chattanooga, TN 37403-2101 | 2006-04-25 |
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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.