Individual provider Active NPI

Sharon Denise Wilson, MA, CCC-SLP

  • Speech-Language Pathologist
  • Santee, SC
National Provider Identifier
1275706145
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4271 Issued in SC
Practice address
109 Graveyard Rock Rd
Santee, SC 29142-8680
Phone
(803) 236-9926
NPI assigned
Apr 10, 2008
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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 4271 SC Primary

Addresses

Primary practice location

109 Graveyard Rock Rd
Santee, SC 29142-8680

Mailing address

109 Graveyard Rock Rd
Santee, SC 29142-8680
Phone (803) 236-9926

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 Arts

State licenses

LicenseStateTypeSpecialty
4271SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1275706145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GRAVEYARD ROCK RD",
            "city": "SANTEE",
            "state": "SC",
            "postal_code": "291428680",
            "telephone_number": "803-236-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 GRAVEYARD ROCK RD",
            "city": "SANTEE",
            "state": "SC",
            "postal_code": "291428680",
            "telephone_number": "803-236-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHARON",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.