Active NPI
Tenisha Walton
- Physical Therapy Assistant
- Addison, TX
National Provider Identifier
1104188069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2088618
- Practice address
- 3820 Vitruvian Way
Apt 115
Addison, TX 75001-4035 - Phone
- (617) 538-6178
- NPI assigned
- Jun 15, 2012
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 2088618 | TX | Primary |
Addresses
Primary practice location
3820 Vitruvian Way
Apt 115
Addison, TX 75001-4035
Mailing address
3820 Vitruvian Way
Apt 115
Addison, TX 75001-4035
Phone (617) 538-6178
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2088618 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407801600000",
"number": "1104188069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3820 VITRUVIAN WAY",
"address_2": "APT 115",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014035",
"telephone_number": "617-538-6178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3820 VITRUVIAN WAY",
"address_2": "APT 115",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014035",
"telephone_number": "617-538-6178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTON",
"first_name": "TENISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2014-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2088618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.