Individual provider Active NPI

Paula Wylie, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Chesterland, OH
National Provider Identifier
1629419874
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP12016 Issued in OH
Practice address
8615 Cedar Rd
Chesterland, OH 44026-3519
Phone
(440) 729-5900
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4852 TN
Speech-Language Pathologist 235Z00000X SP12016 OH Primary

Addresses

Primary practice location

8615 Cedar Rd
Chesterland, OH 44026-3519

Mailing address

8615 Cedar Rd
Chesterland, OH 44026-3519
Phone (440) 665-6731

Other practice location 1

9040 Executive Park Dr
Suite 105
Knoxville, TN 37923-4640
Phone (865) 693-5622

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4852TNMDPharmacist
SP12016OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1629419874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 CEDAR RD",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440263519",
            "telephone_number": "440-665-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 CEDAR RD",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440263519",
            "telephone_number": "440-729-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Executive Park Dr",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234640",
            "country_code": "US",
            "telephone_number": "865-693-5622",
            "fax_number": "865-769-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "PAULA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "4852",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP12016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.