Individual provider Active NPI

Cassie Lynn Wilson, MS, CCC-SLP

  • Speech-Language Pathologist
  • Pell City, AL
National Provider Identifier
1730668674
Registry record updated Aug 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4353 Issued in AL
Practice address
7054 Veterans Pkwy
Pell City, AL 35125-5117
Phone
(205) 227-7985
NPI assigned
Aug 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2018

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 4353 AL Primary

Addresses

Primary practice location

7054 Veterans Pkwy
Pell City, AL 35125-5117

Mailing address

454 Kerr Rd
Odenville, AL 35120-7440
Phone (662) 321-1608

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4353ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1533945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533945600000",
    "number": "1730668674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 KERR RD",
            "city": "ODENVILLE",
            "state": "AL",
            "postal_code": "351207440",
            "telephone_number": "662-321-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7054 VETERANS PKWY",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351255117",
            "telephone_number": "205-227-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CASSIE",
        "middle_name": "LYNN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-11",
        "last_updated": "2018-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "4353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.