Tegan Walters, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0013440 Issued in CO

Practice address

722 S 8TH St
Canon City, CO 81212-4906

Phone

(719) 345-4097

NPI assigned

Feb 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Hudson Group Inc.

  • Physical Therapist
  • Canon City, CO
  • NPI 1871824748
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1104285451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-345-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-345-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "TEGAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA0013440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Frances Wahl, CFNP
• Walgreen Co
• Walgreen Co.
• Walmart Inc.
• Walmart Inc.
• Melissa Watley, LPC, LAC
• Jeremy Allen Weaver, BS
• Lanitta Jane Weaver
• Maria Elena Weaver, PHYSICAL THERAPIST
• Roxanne Weaver, MSW

• Physical Therapy Assistant in Canon City, CO
• Providers in Canon City, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.