Dawn Lucile Wyllie, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G59587 Issued in CA

Practice address

425 7TH St NW
Cass Lake, MN 56633-3360

Phone

(218) 335-3200

Fax

(218) 335-3204

NPI assigned

Aug 14, 2006

Sex

Female

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

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891708871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 MINNESOTA AVE, NE",
            "address_2": "FEDERAL BUILDING, OCS",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-444-0491",
            "fax_number": "218-444-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3200",
            "fax_number": "218-335-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLLIE",
        "first_name": "DAWN",
        "middle_name": "LUCILE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G59587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Washburn, PHARMD
• Danielle Whalen, LPN
• Anna Marie Woods, D.D.S.
• Kathleen Wright, LICSW
• Randall E Wright, RPH
• Heather Rae Zimmel, AUDIOLOGIST

• Family Medicine Physician in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.