Individual provider Active NPI

Michelle Wilson, MM, MS, CF-SLP

  • Speech-Language Pathologist
  • Baltimore, MD
National Provider Identifier
1245695253
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01125L Issued in MD
Practice address
4940 Eastern Ave
Aa Building, Level 01
Baltimore, MD 21224-2735
Phone
(410) 550-0414
Fax
(410) 550-1390
NPI assigned
Dec 17, 2015
Last updated
Dec 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 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 01125L MD Primary

Addresses

Primary practice location

4940 Eastern Ave
Aa Building, Level 01
Baltimore, MD 21224-2735

Mailing address

4940 Eastern Ave
Aa Building, Level 01
Baltimore, MD 21224-2735
Phone (410) 550-0414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170303000722 DC Practitioner - Qualified Speech Language Pathologist 1355625773 Reassigns benefits to 1 organization
I20171101000442 MD Practitioner - Qualified Speech Language Pathologist 1355625773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 1052223229, 196 clinicians
Johns Hopkins UniversityGroup PAC ID 4981745098, 711 clinicians

Practice addresses (Care Compare)

10803 Falls Rd
Lutherville, MD 21093-4502
Phone (410) 583-2665

600 N Wolfe St Jhoc 6TH Floor
Jhu Oto/SLP
Baltimore, MD 21287-0005
Phone (410) 955-9397

6420 Rockledge Dr
Bethesda, MD 20817-7837
Phone (301) 896-6717

8600 Old Georgetown Rd
Bethesda, MD 20814-1497
Phone (301) 896-2578

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
08271MDMDOccupational Therapist
01125LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jul 1, 2017 Accepting new patients
Johns Hopkins University Speech-Language Pathologist CurrentSince Jul 1, 2017 Accepting new patients
Johns Hopkins University CurrentSince Feb 13, 2017 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Feb 13, 2017 Accepting new patients

Locations

4940 Eastern Ave
#1
Baltimore, MD 21224
Phone (410) 550-0120

600 N Wolfe St
#6T
Baltimore, MD 21287
Phone (410) 955-9397

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

Organizations & group practices 5

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1245695253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "AA BUILDING, LEVEL 01",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0414",
            "fax_number": "410-550-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "AA BUILDING, LEVEL 01",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0414",
            "fax_number": "410-550-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MM, MS, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01125L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.