Active NPI
Forrest G. Walker, P.T.
- Physical Therapist
- Boulder, CO
National Provider Identifier
1164526810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2961
- Practice address
- 2955 Baseline Rd
Boulder, CO 80303-2356 - Phone
- (303) 444-8707
- Fax
- (303) 444-8109
- NPI assigned
- Sep 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2961 | CO | Primary |
Addresses
Primary practice location
2955 Baseline Rd
Boulder, CO 80303-2356
Mailing address
815 Dearborn PL
Boulder, CO 80303-3214
Phone (720) 232-4372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2961 | Other | CO | PT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2961 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alta Physical Therapy PC | Past | Accepting new patients |
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.
-
- Specialist
- Boulder, CO
- NPI 1578675120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164526810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 DEARBORN PL",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033214",
"telephone_number": "720-232-4372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 BASELINE RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803032356",
"telephone_number": "303-444-8707",
"fax_number": "303-444-8109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "FORREST",
"middle_name": "G.",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "2961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "2961",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.