Individual provider Active NPI

Wynne Alys Wilking

  • Behavior Technician
  • Fernandina Beach, FL
National Provider Identifier
1669311171
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
95379 Douglas Rd
Fernandina Beach, FL 32034-1272
Phone
(610) 348-0795
NPI assigned
Mar 27, 2026
Last updated
Mar 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

95379 Douglas Rd
Fernandina Beach, FL 32034-1272

Mailing address

95379 Douglas Rd
Fernandina Beach, FL 32034-1272
Phone (610) 348-0795

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

NPI Registry JSON

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

{
    "created_epoch": "1774569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1669311171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95379 DOUGLAS RD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341272",
            "telephone_number": "610-348-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95379 DOUGLAS RD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341272",
            "telephone_number": "610-348-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKING",
        "first_name": "WYNNE",
        "middle_name": "ALYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.