Phyllis D Walker, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11392 Issued in SC

Practice address

1621 Highway 17 N
North Myrtle Beach, SC 29582-2229

Phone

(843) 353-3460

Fax

(843) 353-3461

NPI assigned

Mar 6, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthosc, LLC

  • Orthopaedic Surgery Physician
  • North Myrtle Beach, SC
  • NPI 1568100691
  NPD (past)
• Walker Family Chiropractic, PC

  • Chiropractor
  • Deposit, NY
  • NPI 1922058601
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1295865509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 FRONT ST",
            "city": "DEPOSIT",
            "state": "NY",
            "postal_code": "137541128",
            "telephone_number": "607-467-5858",
            "fax_number": "607-467-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822229",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "PHYLLIS",
        "middle_name": "D",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0075661",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00471498",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11226693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Kayla Renee Walker
• Lawrence Wallace, MD, PT
• Tonya Candice Weber
• David Mark Weitzman, M.D.
• Amy Michele Wendelowski, LPC
• Teresa Werner

• All providers in North Myrtle Beach, SC
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.