Kaylie Nicole Waller, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5219 Issued in OK

Practice address

9070 Harmony Dr
Oklahoma City, OK 73130-6256

Phone

(405) 455-5582

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1720632326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 YALE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731627533",
            "telephone_number": "405-812-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 HARMONY DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731306256",
            "telephone_number": "405-455-5582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9070 Harmony Dr",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731306256",
            "country_code": "US",
            "telephone_number": "405-455-5582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KAYLIE",
        "middle_name": "NICOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Labetta Joyce Wallenmeyer, ARNP
• Andrew Paul Waller, MD
• Catherine Waller, RD/LD, CDE
• Chemeitra Waller
• Elizabeth R Waller, MD
• Nancy Waller, LCSW
• Brittany Elis Walley
• Erin Elizabeth Walling, MD
• Clinton Graves Wallis, M.D.
• Justin Wallis

• Speech-Language Pathologist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.