WESLEY D WYLIE (NPI# 1548215197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548215197 |
| Entity Type | Individual |
| Full Name | WESLEY D WYLIE |
| Credential | M.D. |
| Practice Address |
280 River Park Dr Suite 350 Provo UT 84604-5764 |
| Mailing Address |
1027 Oakridge Rd S Park City UT 84098-5615 |
| Practice Telephone | 8013800432 |
| Practice Fax Number | 8018020108 |
| Mailing Telephone | 8013800432 |
| Mailing Fax Number | 8018020108 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-09-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 187190-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | M-12076 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 11032 | 05 |
| Street Address |
280 RIVER PARK DR SUITE 350 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-5764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467451609 | Bret D Hilton | Physician Assistant | 280 River Park Dr, Suite 120, Provo, UT 84604-5764 | 2005-07-19 |
| 1164887097 | Kristine Emanuelson | Dietary Manager | 280 River Park Dr, Suite 240, Provo, UT 84604-5764 | 2015-12-18 |
| 1083007652 | Si Procedure Center | Clinic/Center | 280 River Park Dr, Suite 200, Provo, UT 84604-5764 | 2015-03-06 |
| 1750704532 | Notus Imaging and Research Laboratories | Radiology | 280 River Park Dr, Suite 100, Provo, UT 84604-5764 | 2014-01-29 |
| 1508292780 | Christian Degrey | Nurse Practitioner | 280 River Park Dr, 200, Provo, UT 84604-5764 | 2013-09-19 |
| 1437383379 | Wesley D Wylie Md LLC | Clinic/Center | 280 River Park Dr, Provo, UT 84604-5764 | 2009-05-06 |
| 1720265432 | J.m. Clayton, Inc. | Plastic Surgery | 280 River Park Dr, Suite 240, Provo, UT 84604-5764 | 2008-01-24 |
| 1174705198 | Thomas D Myers Md PC | Ophthalmology | 280 River Park Dr, Suite 220, Provo, UT 84604-5764 | 2007-11-30 |
| 1366623191 | Catherine R Black | Nurse Practitioner | 280 River Park Dr, Suite 200, Provo, UT 84604-5764 | 2007-11-20 |
| 1588872691 | J Riley Stringham | Pain Medicine | 280 River Park Dr, #200, Provo, UT 84604-5764 | 2007-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453160 | Utah Valley Natural Health Clinic | Family Medicine | 3311 N University Ave Ste 100, Provo, UT 84604-7432 | 2020-10-06 |
| 1750840054 | Jonathon Lee Gross | Family Medicine | 395 W Cougar Blvd Ste 205, Provo, UT 84604-3328 | 2019-03-16 |
| 1275099897 | Optimal Health Family Practice Pllc | Family Medicine | 75 S 200 E Ste 100, Provo, UT 84606-3146 | 2019-02-19 |
| 1518414481 | Ihc Health Services Inc | Family Medicine | 395 W Bulldog Blvd Ste 603, Provo, UT 84604 | 2016-09-08 |
| 1790175628 | Brigham Young University | Family Medicine | 173 Richards Building, Dance Department, Provo, UT 84602-2000 | 2015-01-30 |
| 1790198141 | Micia Roby | Family Medicine | 1055 N 500 W Building A, Provo, UT 84604 | 2014-06-03 |
| 1295171874 | Angel Kae Lybbert | Family Medicine | 395 W. Bulldog Blvd. Suite 6b, Provo, UT 84604 | 2013-05-22 |
| 1912267212 | Ihc Health Services Inc | Family Medicine | 1401 E 2000 S, Provo, UT 84606-2072 | 2012-05-21 |
| 1710250253 | Mark Timothy Ross | Family Medicine | 3737 N 970 E, Provo, UT 84604-5247 | 2012-02-14 |
| 1639497191 | John Frederic Templeman | Family Medicine | 4728 Mile High Dr, Provo, UT 84604-5318 | 2010-05-08 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.