Kristin Nealie Wylie, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67639 Issued in TX

Practice address

1901 Medi Park Dr Ste 212
Amarillo, TX 79106-2107

Phone

(806) 418-2283

Fax

(806) 418-2285

NPI assigned

Sep 5, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Psychological Care Dallas I LLCGroup PAC ID 3375717044, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Senior Psychological Care Dallas I, LLC

  • Psychologist
  • Houston, TX
  • NPI 1649566795

  Professional

  Medicare reassignment Care Compare group NPD
• JK Barton Incorporated

  • Professional Counselor
  • Amarillo, TX
  • NPI 1710313952
  NPD (past) Authorized official

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1992054068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR STE 212",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062107",
            "telephone_number": "806-418-2283",
            "fax_number": "806-418-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR STE 212",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062107",
            "telephone_number": "806-418-2283",
            "fax_number": "806-418-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "KRISTIN",
        "middle_name": "NEALIE",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084295-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virgina Wright
• WTRX Healt Center Inc
• Wyatt Clinic, P.a.
• Douglas B Wyatt, M.D.
• Chris Wylie
• Cassie Wyman, LCSW
• Dustin Wayne Wynne, PHARM. D
• Kaitlyn Wynne, FNP-C
• Di Xia, DDS
• Xpress Eyecare

• Professional Counselor in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.