Active NPI
Kylie Nicole Willson, AUD
- Audiologist
- South Jordan, UT
National Provider Identifier
1891374344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 5119 W Daybreak Pkwy
South Jordan, UT 84009-4858 - Phone
- (801) 417-5734
- NPI assigned
- Apr 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 81251 | TX | |
| Audiologist | 231H00000X | Primary |
Addresses
Primary practice location
5119 W Daybreak Pkwy
South Jordan, UT 84009-4858
Mailing address
5119 W Daybreak Pkwy
South Jordan, UT 84009-4858
Phone (801) 417-5734
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81251 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1891374344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5119 W DAYBREAK PKWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840094858",
"telephone_number": "801-417-5734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5119 W DAYBREAK PKWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840094858",
"telephone_number": "801-417-5734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSON",
"first_name": "KYLIE",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "81251",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.