Organization Active NPI

Hudson & Walker - a Physical Therapy Corporation

  • Physical Therapist
  • San Bernardino, CA
National Provider Identifier
1275845265
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10069 Issued in CA
Legal business name
HUDSON & WALKER - A PHYSICAL THERAPY CORPORATION
Practice address
2131 Elks Dr
102
San Bernardino, CA 92404-5544
Phone
(909) 886-1212
Fax
(909) 886-1228
NPI assigned
Jul 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
William Hudson, RPT
Title
Owner
Phone
(909) 886-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT10069 CA Primary

Addresses

Primary practice location

2131 Elks Dr
102
San Bernardino, CA 92404-5544

Mailing address

2131 Elks Dr
102
San Bernardino, CA 92404-5544
Phone (909) 886-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080122000376 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395826994 2 other NPIs on this enrollment
Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

16018 Tuscola Rd
Ste 6
Apple Valley, CA 92307
Phone (760) 242-8672

2131 Elks Dr
Ste 102
Sn Bernrdno, CA 92404
Phone (909) 886-1212

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1275845265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 ELKS DR",
            "address_2": "102",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045544",
            "telephone_number": "909-886-1212",
            "fax_number": "909-886-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 ELKS DR",
            "address_2": "102",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045544",
            "telephone_number": "909-886-1212",
            "fax_number": "909-886-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON & WALKER - A PHYSICAL THERAPY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-886-1212",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT10069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.