Active NPI
Mary P Walker, PT
- Physical Therapist
- Tullahoma, TN
National Provider Identifier
1174780936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1816 N Washington St
Suite 101
Tullahoma, TN 37388 - Phone
- (931) 393-2378
- Fax
- (931) 455-9983
- NPI assigned
- May 20, 2008
- Last updated
- Aug 25, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1816 N Washington St
Suite 101
Tullahoma, TN 37388
Mailing address
1816 N Washington St
Suite 101
Tullahoma, TN 37388
Phone (931) 393-2378
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1511931 | Medicaid | TN | |
| P00819872 | Other | TN | PALMETTO GBA-RAILROAD MEDICARE |
| 4207028 | Other | TN | BLUE CROSS BLUE SHIELD TENNESSEE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 962 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282694400000",
"number": "1174780936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1816 N WASHINGTON ST",
"address_2": "SUITE 101",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "37388",
"telephone_number": "931-393-2378",
"fax_number": "931-455-9983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1816 N WASHINGTON ST",
"address_2": "SUITE 101",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "37388",
"telephone_number": "931-393-2378",
"fax_number": "931-455-9983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "MARY",
"middle_name": "P",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-20",
"last_updated": "2010-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1511931",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA-RAILROAD MEDICARE",
"identifier": "P00819872",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD TENNESSEE",
"identifier": "4207028",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tullahoma, TN
- Skyler Hayden Vincent
- Volunteer Healing Centers, LLC
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0667)
- Wal-Mart Stores East, LP (Vision Center 30-0667)
- Walgreen Co (Walgreens #06340)
- Stephanie Elaine Walker, FNP
- Kathryn Elizabeth Waller, FNP-C
- Jennifer Ward, NP
- Susan J Warner-Oberwortmann, APN
- Gary Warner
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.