Active NPI
Coedy Walker, PT, DPT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1093183105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1105186
- Practice address
- 11506 Nicholas St
Omaha, NE 68154-4407 - Phone
- (877) 230-3885
- Fax
- (402) 505-9753
- NPI assigned
- Sep 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 1105186 | KS | Primary |
Addresses
Primary practice location
11506 Nicholas St
Omaha, NE 68154-4407
Mailing address
11506 Nicholas St
Omaha, NE 68154-4407
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1105186 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441324800000",
"number": "1093183105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11506 NICHOLAS ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681544407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11506 NICHOLAS ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681544407",
"telephone_number": "877-230-3885",
"fax_number": "402-505-9753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "COEDY",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-04",
"last_updated": "2015-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "1105186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.