Shannon Elizabeth Wylie, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2010024922 Issued in MO

Practice address

300 Floyd Dr
Sikeston, MO 63801-3960

Phone

(573) 472-0397

Fax

(573) 472-0409

NPI assigned

Aug 11, 2010

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

State licenses

Practice roles

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.

• Kenny Rogers Children'S Center

  • Occupational Therapy Assistant
  • Sikeston, MO
  • NPI 1013026194

  Occupational Therapist

  NPD (past)
• Mercy Clinic Children'S Surgery, LLC

  • Pediatric Surgery Physician
  • St. Louis, MO
  • NPI 1649349804
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1366757619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 PEAR TREE CT",
            "address_2": "APARTMENT 1",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012111",
            "telephone_number": "573-690-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FLOYD DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638013960",
            "telephone_number": "573-472-0397",
            "fax_number": "573-472-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2010024922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert P. Wissore, LPC
• Madeline June Witt, COTA/L
• Lashea Worley, MA, CCC-SLP
• Wyatt'S Dream Center
• Wyatt'S Dream Center, LLC
• Christy Rojana Wyman, LCSW
• Hannah Yant, RDN, LDN
• Emily Camille Young
• Lacey Rose Young, MD
• Ashley Zeigler, DENTAL HYGENTIST

• Occupational Therapist in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.