Nikishi Miche Walker, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3130 Issued in OK

Practice address

17110 E 51St St
Broken Arrow, OK 74012-9279

Phone

(918) 355-0758

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Rehab LLCGroup PAC ID 4486794591, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Summit Rehab LLC

  dba Prohab Therapy Specialists

  • Physical Therapist
  • Madill, OK
  • NPI 1447480082
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205984432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 W MONTGOMERY ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127445",
            "telephone_number": "918-798-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17110 E 51ST ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740129279",
            "telephone_number": "918-355-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "NIKISHI",
        "middle_name": "MICHE",
        "name_prefix": "Mrs.",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXISTING BCBSOK PROVIDER#",
            "identifier": "030523284007",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwyna Warrior Walker, BSED MED
• Jasmine Walker
• Karen Walker, PT
• Louie Walker Jr., B.S.
• Michelle Walker
• Robyn Lorraine Walker
• Sade Deonti Walker
• Diana Lee Wall, M.A., LPC
• Cory Wallace, PHARMD
• Raymond M Wallace, COTA/L

• Physical Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Physical Therapist in Oklahoma

• 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.
• 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.