Active NPI
Kenitra Nicole Walker, CTRS
- Recreation Therapist
- Biloxi, MS
National Provider Identifier
1245936657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 83885
- Practice address
- 310 Abbey CT Apt O5
Biloxi, MS 39531-4020 - Phone
- (601) 316-9627
- NPI assigned
- Feb 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 83885 | MS | Primary |
Addresses
Primary practice location
310 Abbey CT Apt O5
Biloxi, MS 39531-4020
Mailing address
4247 Gunar Dr
Byram, MS 39272-4481
Phone (601) 316-9627
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 |
|---|---|---|---|
| 83885 | MS | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1245936657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4247 GUNAR DR",
"city": "BYRAM",
"state": "MS",
"postal_code": "392724481",
"telephone_number": "601-316-9627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 ABBEY CT APT O5",
"city": "BILOXI",
"state": "MS",
"postal_code": "395314020",
"telephone_number": "601-316-9627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "KENITRA",
"middle_name": "NICOLE",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MS",
"license": "83885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.