Dustyn Slade Lee Walton, PT, DPT, ATC

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Practice address

921 S 8TH Ave
Pocatello, ID 83209-0002

Phone

(307) 696-5885

NPI assigned

Nov 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment Care Compare group NPD
• Duke University Health System, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD

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

{
    "created_epoch": "1637971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1164189080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE",
            "address_2": "STOP 8619 APT. I1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83209",
            "telephone_number": "307-696-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "307-696-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "DUSTYN",
        "middle_name": "SLADE LEE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-27",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-5681",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Josara Wallber, AUD
• Sydnee Zaytel Wallentine
• Lyndsay Walls, LSW
• Walter S Medlin MD PC
• Kaitlin Walters
• Amy Rae Wanstrom, LPC
• Ward Clinic PA
• Alexandria Ward
• Kevin Wesley Ward, PT, DPT
• Robert E Ward III, DC, NMD

• Sports Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Sports Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.