Individual provider Active NPI

Wanda Wilson Bowser, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Radcliff, KY
National Provider Identifier
1104228279
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLPLPA00193912 Issued in KY
Practice address
102 Poplar Cir Apt 507
Radcliff, KY 40160-2482
Phone
(270) 370-8309
NPI assigned
Sep 20, 2014
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLPLPA00193912 KY Primary

Addresses

Primary practice location

102 Poplar Cir Apt 507
Radcliff, KY 40160-2482

Mailing address

102 Poplar Cir Apt 507
Radcliff, KY 40160-2482
Phone (270) 370-8309

Other identifiers 1

IdentifierTypeStateIssuer
SLPLPA00193912MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLPLPA00193912KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascb Therapy LLC Speech-Language Pathologist PastSince Apr 19, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1104228279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 POPLAR CIR APT 507",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401602482",
            "telephone_number": "270-370-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 POPLAR CIR APT 507",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401602482",
            "telephone_number": "270-370-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWSER",
        "first_name": "WANDA",
        "middle_name": "WILSON",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "SLPLPA00193912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SLPLPA00193912",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Radcliff, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.