Individual provider Active NPI

Wendy Tyler, LPN

  • Licensed Practical Nurse
  • Brookfield, OH
National Provider Identifier
1932707304
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
146119 Issued in OH
Practice address
7529 Warren Sharon Rd
Brookfield, OH 44403-9796
Phone
(740) 415-1138
NPI assigned
Oct 16, 2020
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 146119 OH Primary

Addresses

Primary practice location

7529 Warren Sharon Rd
Brookfield, OH 44403-9796

Mailing address

4930 Enterprise Dr NW
Warren, OH 44481-8706

Other practice location 1

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 787-0955

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

LicenseStateTypeSpecialty
146119OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora-Recovery, LLC CurrentSince Aug 18, 2024 Accepting new patients
FSR of Parkman LLC CurrentSince Sep 18, 2024 Accepting new patients
Aurora-Recovery, LLC CurrentSince Aug 18, 2024 Accepting new patients

Locations

7529 Warren Sharon Rd
Brookfield, OH 44403
Phone (330) 421-8247

4930 Enterprise Dr NW
Warren, OH 44481
Phone (330) 369-8022

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1932707304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7529 WARREN SHARON RD",
            "city": "BROOKFIELD",
            "state": "OH",
            "postal_code": "444039796",
            "telephone_number": "740-415-1138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4930 Enterprise Dr NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444818706",
            "country_code": "US",
            "telephone_number": "330-787-0955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "WENDY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "146119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.