Kelly M Wilson, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

111168 Issued in TX

Practice address

11330 Farrah
Austin, TX 78748-1959

Phone

(512) 280-2030

NPI assigned

Dec 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1295207462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 KIMONO RIDGE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787485338",
            "telephone_number": "512-905-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 FARRAH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787481959",
            "telephone_number": "512-280-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Wilson, RD
• Kate Cherie Wilson, MS, RDN, LD
• Katlynne Wilson
• Katrijn Seynnaeve Wilson, M.D.
• Kayton Jonathan Riley Wilson, DO
• Kimberly Brijett Wilson, L.P.C.
• Kutia T. Wilson, RN
• Lauren Wilson, M.D.
• Leigh Herrin Wilson, PA-C
• Leslie Ann Wilson

• Speech-Language Pathologist in Austin, TX
• Providers in Austin, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.