Chantee I Wyatt, PA-C is a medicare enrolled "Family Medicine" in Logan, Utah. Her current practice location is
1451 N 200 E Suite #250, Logan, Utah. You can reach out to her office (for appointments etc.) via phone at
(435) 363-7853.
Chantee I Wyatt is licensed to practice in Utah (license number 7766525-1206) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104135326.
Provider's Profile
Full Name | Chantee I Wyatt |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 1451 N 200 E Suite #250, Logan, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104135326
- Provider Enumeration Date: 10/05/2010
- Last Update Date: 10/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 2466641311
- Enrollment ID: I20110107001041
Medical Identifiers
Medical identifiers for Chantee I Wyatt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104135326 | NPI | - | NPPES |
1104135326 | Medicaid | ID | |
PA-1182 | Other | ID | PHYSICIAN ASSISTANT LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA-1182 (Idaho) | Secondary |
207Q00000X | Family Medicine | 7766525-1206 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Chantee I Wyatt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Chantee I Wyatt, PA-C 1451 N 200 E, Suite #250, Logan, UT 84341 Ph: (435) 363-7853 | Chantee I Wyatt, PA-C 1451 N 200 E Suite #250, Logan, UT 84341 Ph: (435) 363-7853 |
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