Mallory Wilson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3888 Issued in KS

Practice address

3795 W 95TH St
Overland Park, KS 66206-2036

Phone

(913) 286-0422

NPI assigned

May 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• KC Developmental Therapies, LLC

  • Speech-Language Pathologist
  • Overland Park, KS
  • NPI 1730513227
  NPD

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1871285155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3795 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662062036",
            "telephone_number": "913-286-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662062036",
            "telephone_number": "913-286-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MALLORY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "3888",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Christine Wilson, M.A., CCC-SLP
• Jon David Wilson, D.C.
• Kathryn Grace Wilson, PHARM-D
• Lauren Wilson
• Luke A Wilson, MD
• Melissa Wilson
• Monica Wilson
• Paige Wilson
• Paul D Wilson
• Shane Marcus Wilson

• Speech-Language Pathologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Speech-Language Pathologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.