SHANNON WYATT NPI 1992151203

NPI Information

NPI: 1992151203
Provider Name: SHANNON WYATT
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Individual
Address:
400 COMMERCE CIR
H
YORKTOWN, VA
ZIP 23693
Phone: (757) 596-2484
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Shannon Wyatt is a prosthetic orthotic supplier in Yorktown, VA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. Shannon Wyatt NPI is 1992151203. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 COMMERCE CIR
H
YORKTOWN, VA
ZIP 23693-322
Phone: (757) 596-2484

The enumeration date for this NPI number is 5/5/2016 and was last updated on 5/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		1202213935	VIRGINIA	No
2	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			No
3	335E00000X	Prosthetic/Orthotic Supplier				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1202213935	OTHER	VIRGINIA	DPOR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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