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WYATT WOODARD MSN FNP PC
NPI 1720082621
Nurse Practitioner - Primary Care in Flagstaff, AZ

Active since June 08, 2005
320 N LEROUX ST, STE B, FLAGSTAFF, AZ 86001(928) 779-0361(928) 779-7143 Get Directions Write a Review

NPPES record last updated: June 8, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Wyatt Woodard Msn Fnp Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WYATT WOODARD MSN FNP PC (NPI 1720082621) is a healthcare organization registered as a primary care in Flagstaff, Arizona and active in the NPI registry since June 2005. The organization lists Wyatt D Woodard, Owner, as its authorized official.

NPPES Registry Identity

NPI1720082621
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameWYATT WOODARD MSN FNP PC
Location Address320 N LEROUX ST, STE BFlagstaff, AZ 86001-4535
Mailing Address320 N Leroux St, Ste BFlagstaff, AZ 86001-4535 · (928) 779-0361 · Fax (928) 779-7143
Phone(928) 779-0361
Fax(928) 779-7143
Organization SubpartNo
Authorized OfficialWyatt D WoodardOwner · (928) 779-0361
Enumeration DateJune 8, 2005
Last NPPES UpdateJune 8, 2011
✔ NPI 1720082621 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in AZ · AP1235
320 N LEROUX ST, Flagstaff, AZ 86001
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified83066AZ · Woodard Fam Prac Grp #

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wyatt Woodard Msn Fnp Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wyatt Woodard Msn Fnp PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Wyatt Woodard, MSN, FNP
Nurse Practitioner
NPI 1013911916
320 N LEROUX ST STE B
Flagstaff, AZ 86001
(928) 779-0361
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wyatt Woodard Msn Fnp PC's NPI number?

The NPI number for Wyatt Woodard Msn Fnp PC is 1720082621. It was assigned to this organization in the NPPES registry on June 8, 2005.

Where is Wyatt Woodard Msn Fnp PC located?

Wyatt Woodard Msn Fnp PC is located at 320 N Leroux St Ste B, Flagstaff, AZ 86001. The listed phone number is (928) 779-0361.

What is Wyatt Woodard Msn Fnp PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Wyatt Woodard Msn Fnp PC enrolled in Medicare?

Yes. Wyatt Woodard Msn Fnp PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wyatt Woodard Msn Fnp PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Wyatt Woodard Msn Fnp PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wyatt Woodard Msn Fnp PC accept?

Health plans from Antidote Health Plan of Arizona, Inc. list Wyatt Woodard Msn Fnp PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wyatt Woodard Msn Fnp PC was last updated on June 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.