Individual provider Active NPI

Daniel J Walters, P.T.

  • Physical Therapist
  • O Fallon, MO
National Provider Identifier
1154375103
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2000145657 Issued in MO
Practice address
3451 Pheasant Meadow Dr
O Fallon, MO 63368-7324
Phone
(636) 379-0092
Fax
(636) 978-8299
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2000145657 MO Primary

Addresses

Primary practice location

3451 Pheasant Meadow Dr
O Fallon, MO 63368-7324

Mailing address

3451 Pheasant Meadow Dr
O Fallon, MO 63368-7324
Phone (636) 379-0092

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

LicenseStateTypeSpecialty
2000145657MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154375103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 PHEASANT MEADOW DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687324",
            "telephone_number": "636-379-0092",
            "fax_number": "636-978-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 PHEASANT MEADOW DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687324",
            "telephone_number": "636-379-0092",
            "fax_number": "636-978-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2000145657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.