Active NPI
Tyler Wilsman
- Hearing Instrument Specialist
- Springfield, IL
National Provider Identifier
1861050445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 3388
- Practice address
- 2300 W White Oaks Dr
Springfield, IL 62704-6423 - Phone
- (217) 698-8153
- NPI assigned
- May 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 3388 | IL | Primary |
Addresses
Primary practice location
2300 W White Oaks Dr
Springfield, IL 62704-6423
Mailing address
119 W Green St
Virden, IL 62690-1319
Phone (815) 883-1259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3388 | Other | IL | ILLINOIS DEPARTMENT OF PUBLIC HEALTH- HEARING INSTRUMENT DISPENSER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3388 | IL | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1861050445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 W GREEN ST",
"city": "VIRDEN",
"state": "IL",
"postal_code": "626901319",
"telephone_number": "815-883-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 W WHITE OAKS DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627046423",
"telephone_number": "217-698-8153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSMAN",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-30",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IL",
"license": "3388",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS DEPARTMENT OF PUBLIC HEALTH- HEARING INSTRUMENT DISPENSER",
"identifier": "3388",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.