Individual provider Active NPI

Taylor Lee Wickey, MA, CCC-SLP

  • Speech-Language Pathologist
  • Golden, CO
National Provider Identifier
1386202257
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14320794 Issued in CO
Practice address
811 Brickyard Cir
Golden, CO 80403-8058
Phone
(330) 241-2760
NPI assigned
Jun 5, 2019
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 14320794 CO Primary

Addresses

Primary practice location

811 Brickyard Cir
Golden, CO 80403-8058

Mailing address

811 Brickyard Cir
Golden, CO 80403-8058
Phone (330) 241-2760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220611000025 CO Practitioner - Qualified Speech Language Pathologist 5294113718 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14320794COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Handprints Outpatient Therapy, LLC Speech-Language Pathologist CurrentSince May 4, 2022 Accepting new patients
Venture Speech LLC Speech-Language Pathologist Current Accepting new patients

Locations

811 Brickyard Cir
Golden, CO 80403
Phone (541) 951-8170

2525 S Wadsworth Blvd
Ste 102
Lakewood, CO 80227

2525 S Wadsworth Blvd
Ste 109
Lakewood, CO 80227

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1386202257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 BRICKYARD CIR",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804038058",
            "telephone_number": "330-241-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 BRICKYARD CIR",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804038058",
            "telephone_number": "330-241-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKEY",
        "first_name": "TAYLOR",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "14320794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.