Active NPI
Wilainia Baskerville, M.S., CCC-SLP
- Speech-Language Pathologist
- Wichita Falls, TX
National Provider Identifier
1285611319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 102098
- Practice address
- 1709 10TH St
Wichita Falls, TX 76301-5010 - Phone
- (940) 696-6200
- Fax
- (940) 696-6210
- NPI assigned
- Dec 29, 2005
- 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 | 102098 | TX | Primary |
Addresses
Primary practice location
1709 10TH St
Wichita Falls, TX 76301-5010
Mailing address
PO Box 8266
Wichita Falls, TX 76307-8266
Phone (940) 696-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1050830 | Other | TX | BLUE LINK # |
| 8T4920 | Other | TX | BCBS PROVIDER # |
| 102098 | Other | TX | HUMANA ID # |
Other names 1
- Ms. Wilainia Street
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102098 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helen Farabee Centers | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Case Management Agency
- Wichita Falls, TX
- NPI 1093833154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502064000000",
"number": "1285611319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8266",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763078266",
"telephone_number": "940-696-6200",
"fax_number": "940-696-6210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1709 10TH ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763015010",
"telephone_number": "940-696-6200",
"fax_number": "940-696-6210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASKERVILLE",
"first_name": "WILAINIA",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-29",
"last_updated": "2017-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "102098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE LINK #",
"identifier": "1050830",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "8T4920",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA ID #",
"identifier": "102098",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WILAINIA",
"last_name": "STREET",
"prefix": "MS.",
"credential": "M.S., CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.