Robert William Wylie, BC-HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HAD 0457 Issued in MS

Practice address

100 Larosa Rd
Ste D
Long Beach, MS 39560

Phone

(228) 863-8050

Fax

(228) 863-1693

NPI assigned

Nov 15, 2010

Last updated

Nov 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1609177179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 HICKORY DR",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603223",
            "telephone_number": "228-863-8050",
            "fax_number": "228-863-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LAROSA RD",
            "address_2": "STE D",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "39560",
            "telephone_number": "228-863-8050",
            "fax_number": "228-863-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "credential": "BC-HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MS",
            "license": "HAD 0457",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "AL",
            "license": "AL 4079",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "LA",
            "license": "1080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing Instrument Specialist in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Hearing Instrument Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.