Misty Wilson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15855 Issued in TX

Practice address

515 W Lingleville Rd
Stephenville, TX 76401-2211

Phone

(254) 965-3611

Fax

(254) 965-3618

NPI assigned

Oct 26, 2006

Last updated

Mar 17, 2018By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Countryside Therapy Group Home Health, LLC

  • Home Health Agency
  • Stephenville, TX
  • NPI 1952713869
  NPD (past)
• Countryside Therapy Group, Inc

  • Rehabilitation Clinic/Center
  • Stephenville, TX
  • NPI 1710999289

  Speech-Language Pathologist

  NPD (past)
• Cowtown Pediatrix Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Fort Worth, TX
  • NPI 1821489121
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407931421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 ELLIS DR UNIT 2",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760884233",
            "telephone_number": "940-452-5972",
            "fax_number": "254-965-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W LINGLEVILLE RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012211",
            "telephone_number": "254-965-3611",
            "fax_number": "254-965-3618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4011 Benbrook Hwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761167800",
            "country_code": "US",
            "telephone_number": "817-386-5500",
            "fax_number": "817-349-9941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MISTY",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "15855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089311704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T5521",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albert Edward White Jr., LCSW
• Morgan White
• Whitney Nicole White, MS., NCC., LPC
• Whitney S Whitford, ATC, LAT
• Madison Wilkerson
• Robert Storey Wilson Sr., D.O.
• Winnie-Stowell Hospital District (Lone Star Rehabilitation & Wellness Center)
• Brandi Wood, PT
• Sarah Yarborough, SLP
• Timothy Zboril, M.D.

• Speech-Language Pathologist in Stephenville, TX
• Providers in Stephenville, 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 Mar 17, 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.