NPIMap

Individual provider Active NPI

Douglas John Wyland, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Spartanburg, SC
National Provider Identifier
1699771121
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
28429 Issued in SC
Practice address
333 S Pine St
Spartanburg, SC 29302-2622
Phone
(864) 515-7500
Fax
(864) 515-7501
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 28429 SC
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 28429 SC Primary

Addresses

Primary practice location

333 S Pine St
Spartanburg, SC 29302-2622

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 2

IdentifierTypeStateIssuer
284294MedicaidSC
P00354702OtherSCMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061101000019 SC Practitioner - Orthopedic Surgery 5799792966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

175 Patewood Dr
Greenville, SC 29615-3570
Phone (864) 797-1403

200 Patewood Dr
Suite C100
Greenville, SC 29615-6322
Phone (864) 454-7422

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

333 S Pine St
Spartanburg, SC 29302-2622
Phone (864) 577-9970

701 Grove Rd
Greenville, SC 29605-4210

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)21
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28429SCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System CurrentSince Mar 10, 2012 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Mary Black Physician Services LLC Orthopaedic Surgery Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Ste C100
Greenville, SC 29615
Phone (864) 454-7422

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

333 S Pine St
Spartanburg, SC 29302
Phone (864) 515-7500

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: dwyland5663@direct.ghs.myhfn.org

Organizations & group practices 5

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.

Hospital & facility affiliations 44

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1699771121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022622",
            "telephone_number": "864-515-7500",
            "fax_number": "864-515-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLAND",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "28429",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": "28429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284294",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00354702",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.