Individual provider Active NPI

Karen P. Wilson

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1679724959
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
438 Issued in NM
Practice address
3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793
Phone
(505) 888-4469
Fax
(505) 889-8142
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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 438 NM Primary

Addresses

Primary practice location

3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793

Mailing address

3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793
Phone (505) 888-4469

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
438NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidpower Therapy Associates Past Accepting new patients

Organizations & group practices 1

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": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1679724959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 PAN AMERICAN FWY NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074793",
            "telephone_number": "505-888-4469",
            "fax_number": "505-889-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 PAN AMERICAN FWY NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074793",
            "telephone_number": "505-888-4469",
            "fax_number": "505-889-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAREN",
        "middle_name": "P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

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

Verify at the official NPI Registry.