Individual provider Active NPI

Wilson Nice, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1205135753
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5194 Issued in NM
Practice address
500 Marquette Ave NW Ste 1200
Albuquerque, NM 87102-5312
Phone
(505) 358-9946
Fax
(833) 455-8353
NPI assigned
Mar 23, 2011
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15254 NC
Speech-Language Pathologist 235Z00000X 5194 NM Primary

Addresses

Primary practice location

500 Marquette Ave NW Ste 1200
Albuquerque, NM 87102-5312

Mailing address

409 N California St
Socorro, NM 87801-4208
Phone (505) 358-9946

Other practice location 1

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone (505) 907-1902

Other practice location 2

409 N California St
Socorro, NM 87801-4208
Phone (505) 358-9946

Other identifiers 2

IdentifierTypeStateIssuer
03260720002-GRTMedicaidNM
1184855181MedicaidNC

Other names 1

  • Bekah Wilson Nice Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210820002535 NM Practitioner - Qualified Speech Language Pathologist 8628473105 Reassigns benefits to 1 organization
I20220803002585 NC Practitioner - Qualified Speech Language Pathologist 8628473105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4030 Wake Forest Rd
Suite 349
Raleigh, NC 27609-0010
Phone (505) 907-1902

604 Reservoir St
Socorro, NM 87801-4333
Phone (505) 358-9946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
15254NCMDSpeech-Language Pathologist
5194NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nice Speech Lady LLC Speech-Language Pathologist CurrentSince Jul 20, 2021 Accepting new patients

Locations

4030 Wake Forest Rd
Ste 349
Raleigh, NC 27609
Phone (336) 280-8301

409 N California St
Socorro, NM 87801
Phone (505) 907-1902

715 N California St
Ste A
Socorro, NM 87801
Phone (505) 358-9946

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1205135753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N CALIFORNIA ST",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014208",
            "telephone_number": "505-358-9946",
            "fax_number": "833-448-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARQUETTE AVE NW STE 1200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871025312",
            "telephone_number": "505-358-9946",
            "fax_number": "833-455-8353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Wake Forest Rd Ste 349",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276090010",
            "country_code": "US",
            "telephone_number": "505-907-1902",
            "fax_number": "855-978-1157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "409 N California St",
            "address_purpose": "LOCATION",
            "city": "Socorro",
            "state": "NM",
            "postal_code": "878014208",
            "country_code": "US",
            "telephone_number": "505-358-9946",
            "fax_number": "833-448-2997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICE",
        "first_name": "WILSON",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15254",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "5194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03260720002-GRT",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184855181",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEKAH",
            "last_name": "NICE",
            "middle_name": "WILSON",
            "credential": "M.A., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.