Active NPI
Kristin R Wells, M.S.
- Speech-Language Pathologist
- Turner, OR
National Provider Identifier
1598895880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12695
- Practice address
- 2783 Ridgeway Dr SE
Turner, OR 97392-9370 - Phone
- (541) 913-4740
- Fax
- (503) 362-8630
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12695 | OR | Primary |
Addresses
Primary practice location
2783 Ridgeway Dr SE
Turner, OR 97392-9370
Mailing address
2783 Ridgeway Dr SE
Turner, OR 97392-9370
Phone (541) 913-4740
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A008 | Other | OR | TRICARE NW |
| 026648000 | Other | OR | BLUE CROSS BLUE SHIELD |
| 247332 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12695 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1598895880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2783 RIDGEWAY DR SE",
"city": "TURNER",
"state": "OR",
"postal_code": "973929370",
"telephone_number": "541-913-4740",
"fax_number": "503-362-8630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2783 RIDGEWAY DR SE",
"city": "TURNER",
"state": "OR",
"postal_code": "973929370",
"telephone_number": "541-913-4740",
"fax_number": "503-362-8630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "KRISTIN",
"middle_name": "R",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "12695",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE NW",
"identifier": "A008",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "026648000",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "247332",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Turner, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.