Active NPI
Nicole Walters
- Pediatric Physical Therapist
- Burlingame, CA
National Provider Identifier
1154875490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- Practice address
- 1541 Old Bayshore Hwy
Burlingame, CA 94010-1602 - Phone
- (650) 638-9142
- Fax
- (650) 638-9141
- NPI assigned
- Aug 3, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | Primary |
Addresses
Primary practice location
1541 Old Bayshore Hwy
Burlingame, CA 94010-1602
Mailing address
1541 Old Bayshore Hwy
Burlingame, CA 94010-1602
Phone (650) 638-9142
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osprey Rehabilitation, LLC. | Past | Accepting new patients | |
| Starfish Physical Therapy Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Physical Therapist
- San Francisco, CA
- NPI 1982881959
Pediatrics
-
- Physical Therapy Clinic/Center
- Linwood, NJ
- NPI 1255064044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1154875490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1541 OLD BAYSHORE HWY",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940101602",
"telephone_number": "650-638-9142",
"fax_number": "650-638-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1541 OLD BAYSHORE HWY",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940101602",
"telephone_number": "650-638-9142",
"fax_number": "650-638-9141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-03",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.