Emma N Wyllie, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE012661 Issued in PA

Practice address

6850 Lows Rd
Bloomsburg, PA 17815

Phone

(570) 784-6860

Fax

(570) 784-5326

NPI assigned

Jul 28, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1245903087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "17815",
            "telephone_number": "570-784-6860",
            "fax_number": "570-784-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "17815",
            "telephone_number": "570-784-6860",
            "fax_number": "570-784-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLLIE",
        "first_name": "EMMA",
        "middle_name": "N",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE012661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Esther Wolfe, CRNP
• Raina Wolfe
• Kayla Wondoloski
• Wendy Woolcock, SLP
• Alexander Wukovitz, D.C.
• Danielle Wysokinski, CRNP
• Shaohua Xu, MD, PHD
• Amanda M Yaskiewicz, LSW
• Joseph J. Yatko, D.M.D.
• Cindy Prusiensky Yocum, M.S.

• Physical Therapy Assistant in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.