Active NPI
Kelly Lynn Walton, PT
- Physical Therapist
- Lakeside Marblehead, OH
National Provider Identifier
1295336360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- OH-10555
- Practice address
- 9400 N Shore Blvd
Lakeside Marblehead, OH 43440-1337 - Phone
- (419) 798-8203
- NPI assigned
- Nov 5, 2020
- Last updated
- Nov 5, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | OH-10555 | OH | Primary |
Addresses
Primary practice location
9400 N Shore Blvd
Lakeside Marblehead, OH 43440-1337
Mailing address
87 N Margaret Dr
Lakeside Marblehead, OH 43440-2514
Phone (419) 217-5272
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 |
|---|---|---|---|
| OH-10555 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1295336360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 N MARGARET DR",
"city": "LAKESIDE MARBLEHEAD",
"state": "OH",
"postal_code": "434402514",
"telephone_number": "419-217-5272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 N SHORE BLVD",
"city": "LAKESIDE MARBLEHEAD",
"state": "OH",
"postal_code": "434401337",
"telephone_number": "419-798-8203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTON",
"first_name": "KELLY",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-05",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "OH-10555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeside Marblehead, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.