Kaitlyn Wilson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-0986 Issued in WV

Practice address

2025 White Oaks Blvd
Bridgeport, WV 26330-5402

Phone

(304) 612-9592

NPI assigned

Aug 4, 2023

Sex

Female

Sole proprietor

Yes

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

Enrolled in WV

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Ona, WV
  • NPI 1336858398

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1972285294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LOFTY LN",
            "city": "MONTANA MINES",
            "state": "WV",
            "postal_code": "265862700",
            "telephone_number": "304-612-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 WHITE OAKS BLVD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263305402",
            "telephone_number": "304-612-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-0986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Ann Williams, LPC
• Hillary Beth Williamson, DDS
• Willo Group
• Jessica Elizabeth Willoughby, MOT, OTR/L
• Catherine Alexis Wilson
• Leslie P Wolford, DMD, MS.
• Susan Michelle Wood, MOTR/L
• Amy Lynn Woodruff, LGSW
• Jamie L Woods, CFNP
• Sarah Lyndsey Woods, FNP-C

• Speech-Language Pathologist in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.