Individual provider Active NPI

Marilee Ann Walker, OTR/L, SCLV

  • Gerontology Occupational Therapist
  • Wilsonville, OR
National Provider Identifier
1104281500
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
OT-1546 Issued in ID
Practice address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone
(971) 224-2040
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X OT-1546 ID Primary

Addresses

Primary practice location

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Mailing address

827 E Riverside Dr # 236
Eagle, ID 83616-5838
Phone (916) 671-6715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170208002961 ID Practitioner - Occupational Therapist in Private Practice 9537442918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chatterton Speech Therapy LLCGroup PAC ID 9234350182, 8 clinicians

Practice addresses (Care Compare)

8601 W Emerald St
Suite 150
Boise, ID 83704-4841
Phone (208) 793-7006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-1546IDMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatterton Speech Therapy, LLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

8601 W Emerald St
Ste 150
Boise, ID 83704
Phone (208) 321-0634

Organizations & group practices 1

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": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1104281500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 E RIVERSIDE DR # 236",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165838",
            "telephone_number": "916-671-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-224-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARILEE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, SCLV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "ID",
            "license": "OT-1546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.

Verify at the official NPI Registry.