Active NPI
Carla M Wiksell, M.A. CCC-SLP
- Speech-Language Pathologist
- Chattanooga, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP0000001023
- Practice address
- 600 N. Holtzclaw - Suite 200
Chattanooga, TN 37404-1240 - Phone
- (423) 622-6900
- Fax
- (423) 622-4834
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP0000001023 | TN | Primary |
| Speech-Language Pathologist | 235Z00000X | SLP003415 | GA |
Addresses
Primary practice location
600 N. Holtzclaw - Suite 200
Chattanooga, TN 37404-1240
Mailing address
600 N. Holtzclaw - Suite 200
Chattanooga, TN 37404-1240
Phone (423) 622-6900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4640001 | Other | TN | UNITEDHEALTHCARE ID# |
| 3060846 | Other | TN | BCBST ID # |
| 3060846 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1023 | TN | MD | Marriage & Family Therapist |
| SLP003415 | GA | MD | Speech-Language Pathologist |
| SP0000001023 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Speech and Hearing Center | Speech-Language Pathologist | Current | Accepting new patients |
| Signal Centers Inc | Speech-Language Pathologist | Current | Accepting new patients |
Locations
600 N Holtzclaw Ave
Ste 200
Chattanooga, TN 37404
Phone (423) 622-6900
6016 Shallowford Rd
Ste 1500
Chattanooga, TN 37421
2212 Encompass Dr
Ste 148
Chattanooga, TN 37421
Phone (423) 622-6900
2217 Encompass Dr
Ste 148
Chattanooga, TN 37421
Organizations & group practices 2
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.
-
- Audiologist
- Chattanooga, TN
- NPI 1386667822
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093738569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N. HOLTZCLAW - SUITE 200",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041240",
"telephone_number": "423-622-6900",
"fax_number": "423-622-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N. HOLTZCLAW - SUITE 200",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041240",
"telephone_number": "423-622-6900",
"fax_number": "423-622-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIKSELL",
"first_name": "CARLA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "SP0000001023",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP003415",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE ID#",
"identifier": "4640001",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST ID #",
"identifier": "3060846",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3060846",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.