Individual provider Active NPI

Patricia Estep Wylie, O.D.

  • Optometrist
  • Glen Dale, WV
National Provider Identifier
1346457207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
675-D Issued in WV
Practice address
1589 Wheeling Ave
Glen Dale, WV 26038-1731
Phone
(304) 845-2480
Fax
(304) 845-9204
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 675-D WV Primary

Addresses

Primary practice location

1589 Wheeling Ave
Glen Dale, WV 26038-1731

Mailing address

1589 Wheeling Ave
Glen Dale, WV 26038-1731
Phone (304) 845-2480

Other names 1

  • Dr. Patricia Estep Wylie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
675WVMDMental Health Counselor
675-DWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Estep-Wylie Optometrist Past Accepting new patients
Charles L. Wylie DDS Group Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346457207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381731",
            "telephone_number": "304-845-2480",
            "fax_number": "304-845-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381731",
            "telephone_number": "304-845-2480",
            "fax_number": "304-845-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "PATRICIA",
        "middle_name": "ESTEP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "675-D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "WYLIE",
            "middle_name": "ESTEP",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Dale, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.