Active NPI
Mark Anthony Walker, PT
- Physical Therapist
- Conroe, TX
National Provider Identifier
1063600591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1177289
- Practice address
- 4015 Interstate 45 N
Conroe, TX 77304-4901 - Phone
- (936) 522-4731
- Fax
- (936) 522-4737
- NPI assigned
- Oct 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1177289 | TX | Primary |
Addresses
Primary practice location
4015 Interstate 45 N
Conroe, TX 77304-4901
Mailing address
4015 Interstate 45 N
Conroe, TX 77304-4901
Phone (936) 522-4731
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00J21A | Other | TX | MEDICARE GROUP |
| 1912875-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6767 Lake Woodlands Dr
The Woodlands, TX 77382-2566
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.05 of 100
- Quality
- 67.43
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1177289 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sterling Ridge Orthopaedics and Sports Medicine, LLC | Current | Accepting new patients | |
| Sterling Ridge Orthopaedics and Sports Medicine, LLC | Current | Accepting new patients |
Locations
20639 Kuykendahl Rd
Ste 200
Spring, TX 77379
Phone (832) 698-0111
6767 Lake Woodlands Dr
#F
The Woodlands, TX 77382
Phone (281) 364-1122
Interoperability endpoints
- mark.walker.1@1066.direct.athenahealth.com
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- The Woodlands, TX
- NPI 1881626117
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Spring, TX
- NPI 1154965739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1063600591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4015 INTERSTATE 45 N",
"city": "CONROE",
"state": "TX",
"postal_code": "773044901",
"telephone_number": "936-522-4731",
"fax_number": "936-522-4737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4015 INTERSTATE 45 N",
"city": "CONROE",
"state": "TX",
"postal_code": "773044901",
"telephone_number": "936-522-4731",
"fax_number": "936-522-4737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "MARK",
"middle_name": "ANTHONY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-10",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1177289",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "00J21A",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912875-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.