Wylie Enterprises, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2421 Issued in AL

Legal business name

WYLIE ENTERPRISES, INC

Doing business as

Providence Chiropractic

Practice address

100 Providence Main St NW
Suite D
Huntsville, AL 35806-4826

Phone

(256) 801-7227

Fax

(256) 361-9942

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Bryan Michael Wylie, D.C.NPI 1043599699

Title

Owner

Phone

(256) 801-7227

Specialties & licenses 1

Addresses

Other names 1

• Providence Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Michael Wylie, D.C.

  • Chiropractor
  • Huntsville, AL
  • NPI 1043599699
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1861821605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROVIDENCE MAIN ST NW",
            "address_2": "SUITE D",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064826",
            "telephone_number": "256-801-7227",
            "fax_number": "256-361-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROVIDENCE MAIN ST NW",
            "address_2": "SUITE D",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064826",
            "telephone_number": "256-801-7227",
            "fax_number": "256-361-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYLIE ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "WYLIE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-801-7227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon Wright
• Thomas Whitten Wright Jr., M.D.
• Yaritza M Wright, DMD
• Kathryn L Wyatt, N.P.
• Ronald M Wyatt, M.D.
• Bryan Michael Wylie, D.C.
• Jerrel Wynn
• William Brandon Wynn, ARNP, FNP-BC
• M Roxanne Wysock, LPC
• Niraj Phillip Xavier, MD

• Chiropractor in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.