MR. JOHN ROBERT JR. WYATT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1205106523

MR. JOHN ROBERT JR. WYATT (CRNA) is a healthcare provider. based in Memphis, Tennessee. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R077091 (AR). The NPI Number for MR. JOHN ROBERT JR. WYATT (CRNA) is 1205106523

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN ROBERT JR. WYATT (CRNA)
NPI
1205106523
Phone
(901) 725-5846
Address
1755 Kirby Pkwy Ste 330
Enumeration Date
3 January 2012
Last Update Date
2 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9016826828
Graduation Year
2011 (15 years ago)
PAC ID
5597925552
Group Practice PAC ID
8921410341
Professional Enrollment ID
I20241112003377
Address ID
MO639011573PO3100XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience83
Completeness75
Years active:14State licenses:5Digital endpointsOther names

2,753 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TN

Provider Addresses for MR. JOHN ROBERT JR. WYATT (CRNA)

  • 1755 Kirby Pkwy Ste 330

    Memphis, TN 381204398

    Phone: (901) 725-5846

    Type: Location

  • 2 ENCLAVE CIRCLE

    PARAGOULD, AR 72450

    Phone:

    Type: Mailing

  • 3 LUKAS CV

    PARAGOULD, AR 724507567

    Phone:

    Type: Mailing

  • 900 W KINGSHIGHWAY

    PARAGOULD, AR 72450

    Phone: (870) 239-7000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120328000804ICertified Registered Nurse Anesthetist (Crna)TNTBD
I20130710000237ICertified Registered Nurse Anesthetist (Crna)ARTBD
I20140605001803ICertified Registered Nurse Anesthetist (Crna)MSTBD
I20241112003377ICertified Registered Nurse Anesthetist (Crna)MOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 38120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921410341View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TN
Anesthesiology, Interventional Pain ManagementMO
Certified Registered Nurse Anesthetist (Crna)AR

Reviews

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Frequently asked questions

What federal number belongs to MR. JOHN ROBERT JR. WYATT (CRNA)?
The federal identifier for MR. JOHN ROBERT JR. WYATT (CRNA) is NPI 1205106523.
Is MR. JOHN ROBERT JR. WYATT (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MR. JOHN ROBERT JR. WYATT (CRNA) work in?
You can think of MR. JOHN ROBERT JR. WYATT (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for MR. JOHN ROBERT JR. WYATT (CRNA)?
We surface Memphis, Tennessee for MR. JOHN ROBERT JR. WYATT (CRNA) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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