Individual provider Active NPI

Lindsay Wilson

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1871899500
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005167A Issued in IN
Practice address
4180 Sage Bluff Xing
Fort Wayne, IN 46804-2363
Phone
(260) 443-7300
NPI assigned
Jan 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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 22005167A IN Primary

Addresses

Primary practice location

4180 Sage Bluff Xing
Fort Wayne, IN 46804-2363

Mailing address

1365 Gateway TRL
Fort Wayne, IN 46845-5502
Phone (260) 417-5052

Other practice location 1

12656 Bourden Ln
Fishers, IN 46037-6282
Phone (260) 417-5052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220804001485 IN Practitioner - Qualified Speech Language Pathologist 6608258884 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

329 Rainbow Dr
Kokomo, IN 46902-3869
Phone (765) 400-2939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22005167AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Aug 1, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jun 21, 2025 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Aug 15, 2025 Accepting new patients
Cortlyn Therapy, PC Speech-Language Pathologist CurrentSince Jul 2, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jun 21, 2025 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Aug 1, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Aug 15, 2025 Accepting new patients

Locations

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

1675 W 7th St
Auburn, IN 46706
Phone (260) 247-6632

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

7900 Rhode Island St
#1504
Merrillville, IN 46410
Phone (219) 649-0625

10 S 9th St
Ste 4
Noblesville, IN 46060

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 7

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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1871899500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 GATEWAY TRL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468455502",
            "telephone_number": "260-417-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 SAGE BLUFF XING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042363",
            "telephone_number": "260-443-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12656 Bourden Ln",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460376282",
            "country_code": "US",
            "telephone_number": "260-417-5052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005167A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.