Carol Y Wyse DO PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

CW007869 Issued in MI

Legal business name

CAROL Y WYSE DO PLC

Practice address

6012 Linden Rd
Suite 14
Swartz Creek, MI 48473-8890

Phone

(810) 655-5900

Fax

(810) 655-5915

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Carol Y Wyse, DO

Title

President

Phone

(810) 655-5900

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1467528315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320945",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485320017",
            "telephone_number": "810-655-5900",
            "fax_number": "810-655-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 LINDEN RD",
            "address_2": "SUITE 14",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484738890",
            "telephone_number": "810-655-5900",
            "fax_number": "810-655-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL Y WYSE DO PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "WYSE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-655-5900",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "CW007869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5250325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080139268",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4079297",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Errol Brown, DC
• Lynn Brown
• Robert Kenneth Brummeler, M.D.
• Gina Marie Campbell, COTA
• Jennifer Carley, PHARMD
• Center for Children and Families
• Rebecca Linn Cervantes, LMSW
• Jennifer Chesser, PHARMD
• Randall Mark Christensen, MS
• Circle of Life Counseling LLC

• Family Medicine Physician in Swartz Creek, MI
• Providers in Swartz Creek, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.