Mark Ryan Wylie, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN260231 Issued in GA

Practice address

106 Shoppers Way
Brunswick, GA 31525-0530

Phone

(912) 265-7660

NPI assigned

Jan 5, 2020

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McLaulin Practice LLC

  • Adult Mental Health Clinic/Center
  • Waverly, GA
  • NPI 1366865719
  NPD (past)

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

{
    "created_epoch": "1578182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1861031023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SHOPPERS WAY",
            "address_2": "STE 115",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250522",
            "telephone_number": "912-265-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SHOPPERS WAY",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250530",
            "telephone_number": "912-265-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "MARK",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Mary Woods, MENTAL HEALTH COACH
• Angela Worley, LMT
• Hannah M Wright, RBT
• Lorieann Wright, N.P.
• Malcolm G. Wright, M. D.
• Lavonne Wynn, RN
• Patricia Yates-Rand
• Henry Bert Yeargan Jr., DMD
• Henry Bert Yeargan Sr., DMD
• Shyamala Yennam, MD

• Family Nurse Practitioner in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.