Marc Bryan Walton

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT2513 Issued in CA

Practice address

2418 Erie Dr
Concord, CA 94519-2155

Phone

(215) 888-4452

NPI assigned

Oct 29, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1215116017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 INTERNATIONAL PKWY",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327465303",
            "telephone_number": "800-798-6035",
            "fax_number": "888-798-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 ERIE DR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192155",
            "telephone_number": "215-888-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "MARC",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP003008L",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OT2513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OP003008L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE  LICENSE",
            "identifier": "OTA2513",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willa Walter
• Martin Edward Walters, SUDCC1-7897
• Paige Walters
• Saprina L Walters
• Keerah Walton
• Michael Marcus Walton
• Rachel Walton
• Zachary Thomas Wandishin
• Catherine Wang, M.D.
• Chenghua Wang

• Occupational Therapy Assistant in Concord, CA
• Providers in Concord, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.