Individual provider Active NPI

Tomi Lynn Wilson-Keiser, MS, CCC-SLP

  • Speech-Language Pathologist
  • Tacoma, WA
National Provider Identifier
1124191507
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60122969 Issued in WA
Practice address
3919 S 19TH St
Tacoma, WA 98405-1414
Phone
(503) 891-1511
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X LL60122969 WA Primary
Speech-Language Pathologist 235Z00000X SP17814 CA

Addresses

Primary practice location

3919 S 19TH St
Tacoma, WA 98405-1414

Mailing address

PO Box 64504
University Place, WA 98464-0504

Other names 1

  • Tomi Lynn Wilson Former name

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
17814CAMDOccupational Therapist
SP17814CAMDSpeech-Language Pathologist
LL60122969WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1124191507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64504",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984640504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 S 19TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051414",
            "telephone_number": "503-891-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-KEISER",
        "first_name": "TOMI",
        "middle_name": "LYNN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60122969",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP17814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMI",
            "last_name": "WILSON",
            "middle_name": "LYNN",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.