Individual provider Active NPI

Christie Paschal Wilson, MS CCC/SLP

  • Speech-Language Pathologist
  • Fort Payne, AL
National Provider Identifier
1356573752
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2026 Issued in AL
Practice address
200 Medical Center Dr SW
Fort Payne, AL 35968
Phone
(256) 997-2460
NPI assigned
Aug 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP007845 GA
Speech-Language Pathologist 235Z00000X 2026 AL Primary

Addresses

Primary practice location

200 Medical Center Dr SW
Fort Payne, AL 35968

Mailing address

251 Johnston St SE Ste 200
Decatur, AL 35601-2515
Phone (256) 350-1764

Other practice location 1

1234 Highway 301
Trenton, GA 30752-4727
Phone (256) 605-3024

Other practice location 2

1234 Highway 301
Trenton, GA 30752-4727
Phone (256) 605-3024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190224000001 AL Practitioner - Qualified Speech Language Pathologist 3476892159 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2026ALMDSpeech-Language Pathologist
SLP007845GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc CurrentSince Dec 17, 2018 Accepting new patients
Encore Rehabilitation, Inc. CurrentSince Dec 17, 2018 Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Locations

22423 US Highway 72
Ste B
Athens, AL 35613
Phone (256) 232-1211

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

615 Mynatt St SW
Ste A
Hartselle, AL 35640
Phone (256) 773-0138

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1356573752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "35968",
            "telephone_number": "256-997-2460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Highway 301",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "GA",
            "postal_code": "307524727",
            "country_code": "US",
            "telephone_number": "256-605-3024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Highway 301",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "GA",
            "postal_code": "307524727",
            "country_code": "US",
            "telephone_number": "256-605-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTIE",
        "middle_name": "PASCHAL",
        "name_prefix": "Mrs.",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007845",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "2026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.