Samantha S Wyatt
Dermatology

Address: 620 Walnut St Ne, Suite A, Decatur, AL 35601-2456
Phone: 2563537775

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).

Provider Overview

Nation Provider Identifier (NPI) 1942247150
Entity Type Individual
Full Name Samantha S Wyatt
Credential M.D.
Gender Female
Practice Address 620 Walnut St Ne
Suite A
Decatur
AL 35601-2456
Practice Telephone 2563537775
Practice Fax Number 2563537765
Mailing Address 620 Walnut St Ne
Suite A
Decatur
AL 35601-2456
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-05-31
Last Update Date 2013-12-18

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207N00000X Dermatology Allopathic & Osteopathic Physicians 00026547 AL

Other Provider Identifier

State Identifier Issuer Type Code
AL 51001088 OTHER BCBS AL PROVIDER#
AL 009932289 MEDICAID
AL 529924440 MEDICAID

Other Providers SAMANTHA WYATT

NPI Name Taxonomy Address Enumeration
1982890208 Samantha Wyatt Speech-Language Pathologist 518 W Fletcher Ave, Tampa, FL 33612-3419 2007-09-20

Physician Overview

NPI 1942247150
PAC ID by PECOS 9234183146
Professional Enrollment ID I20050823000933
Full Name Samantha Wyatt
Gender F
Credential MD
Medical School UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year 2001
Primary Specialty DERMATOLOGY
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
010085 DECATUR MORGAN HOSPITAL - DECATUR CAMPUS

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_137_1 Melanoma: Continuity of Care - Recall System 100%
PQRS_EP_224_1 Melanoma: Overutilization of Imaging Studies in Melanoma 100%

Office Location

Street Address 620 WALNUT ST NE
SUITE A
City DECATUR
State AL
Zip Code 35601-2456

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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 Facility, Mental Retardati 107 B 14th Street Sw, Decatur, AL 35601 2014-07-02
1366794711 Complete Dental Decatur LLC Dentist 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 2012-10-10
1245505536 Urology Associates of North Alabama Urology 1874 Beltine Road, Sw, Suite 106, Decatur, AL 35601 2012-03-20
1265741557 A Caring Place Home Health 432 Moulton Street, E, Decatur, AL 35601 2010-10-04
1427375286 Kimberly Ann Donohue Dietitian, Registered 1874 Beltine Rd, Decatur, AL 35601 2010-05-03
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164919403 Dermdoc Dermatology Atlanta, LLC. 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
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
1700369717 Dermatology Solutions Pllc Dermatology 609 Medical Center Dr, Decatur, TX 76234-3836 2018-09-14
1174709711 Holly L Hanson Dermatology 1951 Clairmont Rd, Decatur, GA 30033-3415 2008-01-14
1518143361 Emma J Murad Dermatology 1951 Clairmont Rd, Decatur, GA 30033-3415 2008-01-10
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City DECATUR
Zip Code 35601

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Dataset Information

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.

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