Kellie Natasha Wilson, M.ED. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

102896 Issued in TX

Practice address

15015 W Airport Blvd Apt 612
Sugar Land, TX 77478-7087

Phone

(281) 242-5913

NPI assigned

Apr 1, 2008

Sex

Female

Sole proprietor

Yes

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

Enrolled in TX

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1083886816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15015 W AIRPORT BLVD APT 612",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774787087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 W AIRPORT BLVD APT 612",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774787087",
            "telephone_number": "281-242-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLIE",
        "middle_name": "NATASHA",
        "name_prefix": "Ms.",
        "credential": "M.ED. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilson Almonte, MD, PLLC
• Wilson Psychological & Forensic Services, PLLC
• Anugraha Wilson, DMD
• Arlether Wilson, PHD, LPC, LCDC, MAC
• Jodi Elizabeth Wilson, D.C.
• Melanie Wilson, RPH
• Patrice Wilson
• Tanisha Wilson, RN, BSN
• Daniel Wayne Wimberly
• Jamie Lynn Winderweedle Wall, AU.D., CCC/A

• Speech-Language Pathologist in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.