Amy Katherine Wyllie, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11507 Issued in MA

Practice address

14 Williams St Apt B10
Danvers, MA 01923-1988

Phone

(774) 279-4097

NPI assigned

Nov 18, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powerback Rehabilitation of Ma, PC

  • Physical Therapist
  • South Hamilton, MA
  • NPI 1194688341
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1013510437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WILLIAMS ST APT B10",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231988",
            "telephone_number": "774-279-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WILLIAMS ST APT B10",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231988",
            "telephone_number": "774-279-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLLIE",
        "first_name": "AMY",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "11507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara Wosepka
• Theresa Wray
• Michelle Wright, MA
• Write Sensations LLC
• Emma Y, Wu, D.M.D.
• Katia Wyman
• Ronald Michael Wyner, R.PH.
• Andrea Wynn
• Marilyn Yacinthe
• Peter C. Yang, M.D.

• Occupational Therapist in Danvers, MA
• Providers in Danvers, MA by specialty
• Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.