SAMANTHA S WYATT (NPI# 1942247150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942247150 |
| Entity Type | Individual |
| Full Name | SAMANTHA S WYATT |
| Credential | M.D. |
| Practice Address |
620 Walnut St Ne Suite A Decatur AL 35601-2456 |
| Practice Telephone | 2563537775 |
| Practice Fax Number | 2563537765 |
| Mailing Telephone | 2563537775 |
| Mailing Fax Number | 2563537765 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2013-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 00026547 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS AL PROVIDER# | 51001088 | 01 |
| AL | 009932289 | 05 | |
| AL | 529924440 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982890208 | Samantha Wyatt | Speech-Language Pathologist | 518 W Fletcher Ave, Tampa, FL 33612-3419 | 2007-09-20 |
| Street Address |
620 WALNUT ST NE SUITE A |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-2456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164919403 | Dermdoc Atlanta | Dermatology | 4150 Snapfinger Woods Dr Ste 210, Decatur, GA 30035-3417 | 2018-04-20 |
| 1548649387 | Lakenya Odom | Dermatology | 18004 Anwar Trl, Decatur, GA 30032-7414 | 2015-05-26 |
| 1396916219 | Kathleen Jeanne Smith | Dermatology | 1670 Scott Blvd Ste 202, Decatur, GA 30033-5645 | 2008-03-19 |
| 1467574343 | Novie Sroa | Dermatology | 2000 Ben Merritt Dr Ste B, Decatur, TX 76234-3848 | 2007-04-04 |
| 1649237363 | Joseph Thomas Backe | Dermatology | 1203 Medical Dr Se, Decatur, AL 35601 | 2006-04-27 |
| 1972588648 | James L Reeder Sr. | Dermatology | 1310 Somerville Rd Se, Decatur, AL 35601-4317 | 2005-12-14 |
| 1396735114 | Francis Chaepoong Lee | Dermatology | 606 W Pershing Rd, Suite E, Decatur, IL 62526-1633 | 2005-10-24 |
| 1265436067 | Jere H Weaver | Dermatology | 722 Bank St Ne, Decatur, AL 35601-1610 | 2005-06-09 |
| 1710450838 | Dermdoc Atlanta, LLC. | Dermatology | 4150 Snapfinger Woods Dr Ste 210, Decatur, GA 30035-3417 | 2019-01-11 |
| 1700369717 | Dermatology Solutions Pllc | Dermatology | 609 Medical Center Dr, Decatur, TX 76234-3836 | 2018-09-14 |
| Find all providers in DECATUR | ||||
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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.