Individual provider Active NPI

Nancy J Walsh, P.T.

  • Geriatric Physical Therapist
  • Chicago Heights, IL
National Provider Identifier
1003046251
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
070011814 Issued in IL
Practice address
100 197TH PL
Chicago Heights, IL 60411-7539
Phone
(708) 755-3020
NPI assigned
Jul 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 070011814 IL Primary

Addresses

Primary practice location

100 197TH PL
Chicago Heights, IL 60411-7539

Mailing address

3403 W Oakhill Dr
Crete, IL 60417-1965
Phone (708) 534-1712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011003673 WI Practitioner - Physical Therapist in Private Practice 2668904830 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070011814ILMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services, Inc CurrentSince Nov 23, 2024 Accepting new patients
Medical Services, Inc CurrentSince Nov 23, 2024 Accepting new patients

Locations

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

Organizations & group practices 2

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1003046251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 W OAKHILL DR",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604171965",
            "telephone_number": "708-534-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 197TH PL",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604117539",
            "telephone_number": "708-755-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070011814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.