Bradley Wylie

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

175 N Groesbeck Hwy
Mount Clemens, MI 48043

Phone

(586) 627-0024

NPI assigned

Oct 3, 2018

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)

Not enrolled

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1982179156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "313-278-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-627-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Wooten II
• Amy Wright, D.O.
• Hailey Madison Wright
• Katherine Michele Wu, DO
• Stephen Say Wu, DO
• Hussein Yassine, DDS
• John V Yax III, LMSW
• Firas Yazigi, M.D.
• Eugene C Yen, D.O.
• Steven Richard Yester Jr., D.O.

• Case Manager/Care Coordinator in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.