Micah Alden Wylie, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17838 Issued in OR

Practice address

3720 N Clarey St
Eugene, OR 97402-8744

Phone

(458) 201-4936

NPI assigned

Aug 21, 2024

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1285467720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 FIR ACRES DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011884",
            "telephone_number": "310-666-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 N CLAREY ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974028744",
            "telephone_number": "458-201-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "MICAH",
        "middle_name": "ALDEN",
        "name_prefix": "Mr.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tzu-Chin Wu
• Megan A Wuest, MS LPA
• Thomas Wuest, MD
• Michelle T Wyatt, M.D.
• Trisha C Wygant, RN
• Arli Wynn, LMT
• Patricia Anne Wyss, FNP
• Peter Wyzinski, MD
• Kristin Tillie Xander
• Xia LLC

• Speech-Language Pathologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.