Bethany Wyles

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

34-007778 Issued in OH

Practice address

687 Hopewell Dr BLDG 2
Heath, OH 43056-1579

Phone

(220) 564-1755

Fax

(220) 564-1756

NPI assigned

Jul 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Dermatology

Education

Ohio University, College of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score

85.98 of 100Reported as group

Quality

75.66

Promoting interoperability

100

Improvement activities

40

Cost

75.38

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265
  Medicare reassignment Care Compare group NPD
• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD
• Licking Memorial Professional Corp.

  • Surgery Physician
  • Newark, OH
  • NPI 1366461386
  NPD (past)
• Licking Memorial Professional Corp.

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1245238120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 HOPEWELL DR BLDG 2",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561579",
            "telephone_number": "220-564-1755",
            "fax_number": "220-564-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 HOPEWELL DR BLDG 2",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561579",
            "telephone_number": "220-564-1755",
            "fax_number": "220-564-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLES",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "34-007778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2386814",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwyles14443@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "687 Hopewell Dr Bldg 2",
            "city": "Heath",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430561579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dodi Katrina Wilson, LMT
• Winds of Change Counseling
• Craig S Wolf, O.D.
• Jaela Wollenburg
• Michelle Wollenburg
• Amy L Yaiser, RN
• Nichole T Yoder, PHARMD

• Dermatology Physician in Heath, OH
• Providers in Heath, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.