Jayme Robert Wilson, MA,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12029617 Issued in MI

Practice address

3285 Martin Rd
Suite 104
Commerce Township, MI 48390-1601

Phone

(248) 669-1230

Fax

(248) 669-4745

NPI assigned

Sep 9, 2010

Last updated

Sep 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1932416138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 MARTIN RD",
            "address_2": "SUITE 104",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483901601",
            "telephone_number": "248-669-1230",
            "fax_number": "248-669-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 MARTIN RD",
            "address_2": "SUITE 104",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483901601",
            "telephone_number": "248-669-1230",
            "fax_number": "248-669-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAYME",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12029617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.