Active NPI
Caitlin Michelle Wilson, SLP
- Speech-Language Pathologist
- Locust Grove, OK
National Provider Identifier
1255177044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 650
- Practice address
- 302 Joe Koelsch Dr
Locust Grove, OK 74352 - Phone
- (918) 479-5243
- NPI assigned
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 650 | OK | Primary |
Addresses
Primary practice location
302 Joe Koelsch Dr
Locust Grove, OK 74352
Mailing address
320 NE 4418
Salina, OK 74365-2472
Phone (918) 718-4558
Other practice location 1
1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641 ext. 6870
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1255177044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 NE 4418",
"city": "SALINA",
"state": "OK",
"postal_code": "743652472",
"telephone_number": "918-718-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 JOE KOELSCH DR",
"city": "LOCUST GROVE",
"state": "OK",
"postal_code": "74352",
"telephone_number": "918-479-5243"
}
],
"practiceLocations": [
{
"address_1": "1400 E Downing St",
"address_purpose": "LOCATION",
"city": "Tahlequah",
"state": "OK",
"postal_code": "744643324",
"country_code": "US",
"telephone_number": "918-456-0641 x6870",
"fax_number": "918-506-6902",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "CAITLIN",
"middle_name": "MICHELLE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Locust Grove, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.