Theresa Walter, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011412 Issued in MI

Practice address

107 Schoolcrest Ave
Clare, MI 48617-1145

Phone

(989) 386-9170

Fax

(989) 386-9220

NPI assigned

Apr 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1265939664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N SAGINAW RD STE C",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402690",
            "telephone_number": "989-386-9170",
            "fax_number": "989-386-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SCHOOLCREST AVE",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171145",
            "telephone_number": "989-386-9170",
            "fax_number": "989-386-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "THERESA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macy V Tyler, LLMSW
• Cassidee Utterback, BCBA, M.ED.
• Robert Vanderbrook, M.D.
• Lisa Anne Velchansky, CMT
• Walgreen Co
• Maureen Wargo
• Katherine S Watson, NP
• Amy Ellen Weber, FNP
• Frances Wenzel, DPT
• Daniel K. Wild, D.C.

• Physical Therapist in Clare, MI
• Providers in Clare, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.