Individual provider Active NPI

Kelly April Stilwell, MS, CCC-SLP

  • Speech-Language Pathologist
  • Sedro Woolley, WA
National Provider Identifier
1104296532
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
60583733 Issued in WA
Practice address
801 Trail Rd
Sedro Woolley, WA 98284-9387
Phone
(360) 855-3871
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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 60583733 WA Primary

Addresses

Primary practice location

801 Trail Rd
Sedro Woolley, WA 98284-9387

Mailing address

433 Spring LN
Sedro Woolley, WA 98284-8082
Phone (360) 855-3871

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
60583733WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1104296532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SPRING LN",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982848082",
            "telephone_number": "360-855-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TRAIL RD",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982849387",
            "telephone_number": "360-855-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "KELLY",
        "middle_name": "APRIL",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60583733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.