Active NPI
Adam Wylie
- Student in an Organized Health Care Education/Training Program
- Wilkes Barre, PA
National Provider Identifier
1225557382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 133 N Main St
Wilkes Barre, PA 18702 - Phone
- (904) 738-9469
- NPI assigned
- Sep 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
133 N Main St
Wilkes Barre, PA 18702
Mailing address
208 13TH St
Belmont, NC 28012
Phone (704) 517-1008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505001600000",
"number": "1225557382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 13TH ST",
"city": "BELMONT",
"state": "NC",
"postal_code": "28012",
"telephone_number": "704-517-1008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 N MAIN ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "18702",
"telephone_number": "904-738-9469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYLIE",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-10",
"last_updated": "2017-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.