WYATT JOSEPH MCCRACKIN (NPI# 1922554435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922554435 |
| Entity Type | Individual |
| Full Name | WYATT JOSEPH MCCRACKIN |
| Practice Address |
3501 Highway 308 Galivants Ferry SC 29544-7317 |
| Practice Telephone | 8433588794 |
| Mailing Telephone | 8433588794 |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3501 HIGHWAY 308 |
| City | GALIVANTS FERRY |
| State | SC |
| Zip Code | 29544-7317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851615272 | Little River Medical Center, Inc. | Dentist | 3011 Nichols Hwy, Galivants Ferry, SC 29544-6059 | 2010-03-15 |
| 1164999702 | Candice Fiorini | Social Worker | 2210 Highway 129, Galivants Ferry, SC 29544-6879 | 2018-11-01 |
| 1023435633 | Kelly Driggers | Registered Nurse | 1384 Bud Graham Rd, Galivants Ferry, SC 29544-7101 | 2014-03-20 |
| 1427696475 | Porscha Rush | Nurse Practitioner | 1040 Frye Rd, Galivants Ferry, SC 29544-8018 | 2019-12-19 |
| 1942549761 | Kristi Michelle Watson-foor | Massage Therapist | 3560 Jordanville Rd, Galivants Ferry, SC 29544-8540 | 2013-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427696475 | Porscha Rush | Nurse Practitioner | 1040 Frye Rd, Galivants Ferry, SC 29544-8018 | 2019-12-19 |
| 1164999702 | Candice Fiorini | Social Worker | 2210 Highway 129, Galivants Ferry, SC 29544-6879 | 2018-11-01 |
| 1023435633 | Kelly Driggers | Registered Nurse | 1384 Bud Graham Rd, Galivants Ferry, SC 29544-7101 | 2014-03-20 |
| 1942549761 | Kristi Michelle Watson-foor | Massage Therapist | 3560 Jordanville Rd, Galivants Ferry, SC 29544-8540 | 2013-02-14 |
| 1851615272 | Little River Medical Center, Inc. | Dentist | 3011 Nichols Hwy, Galivants Ferry, SC 29544-6059 | 2010-03-15 |
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141327 | Anne M. Stollberg | Student in an Organized Health Care Education/Training Program | 3 Pheasant Ct, Greenville, SC 29607-5441 | 2020-07-15 |
| 1891313292 | Zachary Blake Riggs | Student in an Organized Health Care Education/Training Program | 2025 Gervais St Unit 321c, Columbia, SC 29204-1803 | 2020-07-12 |
| 1144848797 | Katrina Marie Linenko | Student in an Organized Health Care Education/Training Program | 1051 Southern Dr Unit 3707c, Columbia, SC 29201-5622 | 2020-07-10 |
| 1275151870 | Soo Ji Mun | Student in an Organized Health Care Education/Training Program | 3049 Gedney Circle, Blythewood, SC 29016 | 2020-07-09 |
| 1790303402 | Kaitlyn Michele Pierce | Student in an Organized Health Care Education/Training Program | 1051 Southern Dr Unit 1905c, Columbia, SC 29201-5607 | 2020-07-09 |
| 1932727625 | Kati Mathis | Student in an Organized Health Care Education/Training Program | 907 Canterbury Rd, Anderson, SC 29621-1401 | 2020-07-08 |
| 1316565211 | Erin Maureen Bryant | Student in an Organized Health Care Education/Training Program | 811 Polo Rd Apt 517, Columbia, SC 29223-4426 | 2020-07-08 |
| 1790303634 | Benjamin Dillion | Student in an Organized Health Care Education/Training Program | 800 Alexander Rd Apt 354, Cayce, SC 29033-4383 | 2020-07-08 |
| 1265050132 | Leona Joyce Keller | Student in an Organized Health Care Education/Training Program | 1051 Southern Dr Unit 901, Columbia, SC 29201-5194 | 2020-07-08 |
| 1922626720 | Brett William Elder | Student in an Organized Health Care Education/Training Program | 1051 Southern Dr Unit 3707, Columbia, SC 29201-5622 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | GALIVANTS FERRY |
| Zip Code | 29544 |
Please comment or provide details below to improve the information on WYATT JOSEPH MCCRACKIN.
| 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.