Active NPI
Denton H. Wyse, MD
- Psychiatry Physician
- Archbold, OH
National Provider Identifier
1285728493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35036443
- Practice address
- 22927 County Road J
Archbold, OH 43502-9747 - Phone
- (216) 469-3215
- Fax
- (216) 651-5531
- NPI assigned
- Oct 3, 2006
- Last updated
- Aug 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35036443 | OH | Primary |
Addresses
Primary practice location
22927 County Road J
Archbold, OH 43502-9747
Mailing address
22927 County Road J
Archbold, OH 43502-9747
Phone (216) 469-3215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0329166 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35036443 | OH | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1285728493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22927 COUNTY ROAD J",
"city": "ARCHBOLD",
"state": "OH",
"postal_code": "435029747",
"telephone_number": "216-469-3215",
"fax_number": "216-651-5531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22927 COUNTY ROAD J",
"city": "ARCHBOLD",
"state": "OH",
"postal_code": "435029747",
"telephone_number": "216-469-3215",
"fax_number": "216-651-5531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYSE",
"first_name": "DENTON",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "35036443",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0329166",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Archbold, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.