Kathryn Durham Wilson, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12513 Issued in NC

Practice address

2412 Tweedmore CT
High Point, NC 27265-9303

Phone

(919) 210-5457

NPI assigned

May 6, 2019

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 names 1

• Tyler Durham Wilson Other name

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1558926501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 TWEEDMORE CT",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659303",
            "telephone_number": "919-210-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 TWEEDMORE CT",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659303",
            "telephone_number": "919-210-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHRYN",
        "middle_name": "DURHAM",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "12513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "WILSON",
            "middle_name": "DURHAM",
            "credential": "MA, CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel B Willingham, CRNA
• Taylor Wren Willis, MS, CCC-SLP
• Amelia Claire Wilson, D.D.S.
• Hannia Roxanne Theodosia Wilson, PMHNP
• Jennifer Marie Wilson, CRNA
• Katurah Lashun Wilson, RN
• Lauren Allen Wilson
• Melissa Wilson, LPN, OTC, CPED, BOCO
• Monica Brittain Wilson, PHARMD, BCACP, CPP
• Tierra Wilson

• Speech-Language Pathologist in High Point, NC
• Providers in High Point, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.