Sandra Kay Wiley, BSN, CCP, LP

Primary specialty

PerfusionistTaxonomy code 242T00000X

License

PF0138 Issued in TX

Practice address

102 Ottawa Run
Shavano Park, TX 78231-1455

Phone

(210) 493-7379

Fax

(210) 493-9567

NPI assigned

Aug 31, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing

State licenses

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1730495524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OTTAWA RUN",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311455",
            "telephone_number": "210-493-7379",
            "fax_number": "210-493-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 OTTAWA RUN",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311455",
            "telephone_number": "210-493-7379",
            "fax_number": "210-493-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "BSN, CCP, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "TX224548",
            "primary": false
        },
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "TX",
            "license": "PF0138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Perfusionist in Shavano Park, TX
• Providers in Shavano Park, TX by specialty
• Perfusionist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.