Individual provider Active NPI

Hollis Sherman Wylie, DO

  • Internal Medicine Physician
  • Augusta, GA
National Provider Identifier
1235815135
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15177 Issued in GA
Practice address
1120 15TH Street
Augusta, GA 30912
Phone
(706) 294-0063
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15177 GA Primary

Addresses

Primary practice location

1120 15TH Street
Augusta, GA 30912

Mailing address

2846 Walton Way Apt 17
Augusta, GA 30909-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721003323 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6901266980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15177GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1235815135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 WALTON WAY APT 17",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-294-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "HOLLIS",
        "middle_name": "SHERMAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "15177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.