Kelli Wiltbank, SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14763 Issued in AZ

Practice address

24937 S Sossaman Rd
Queen Creek, AZ 85142-6571

Phone

(480) 826-0847

NPI assigned

Jan 6, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1992419741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20217 E CHANDLER HEIGHTS RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24937 S SOSSAMAN RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426571",
            "telephone_number": "480-826-0847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852015818",
            "country_code": "US",
            "telephone_number": "480-668-1917",
            "fax_number": "480-668-2750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILTBANK",
        "first_name": "KELLI",
        "credential": "SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "14763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316163884",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Williams, SLP
• Dena Willmann, LPC
• Dana Willyerd
• Emily Wilson
• Nicholas Wilson
• Winchester Care, LLC
• Annette Winsor
• Kelle Witt, BCBA
• Jill Wolfe, FNP-C
• Kevin Wolff, DMD

• Speech-Language Pathologist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.