Active NPI
Jill Walker, PT
- Physical Therapist
- Saint Peters, MO
National Provider Identifier
1417770280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2003016759
- Practice address
- 711 Garden Bounty Dr
Saint Peters, MO 63376-3873 - Phone
- (636) 448-7868
- NPI assigned
- Oct 31, 2024
- Last updated
- Oct 31, 2024
- 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 | 2003016759 | MO | Primary |
Addresses
Primary practice location
711 Garden Bounty Dr
Saint Peters, MO 63376-3873
Mailing address
7068 S Outer 364
O Fallon, MO 63368-7757
Phone (636) 448-7868
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 |
|---|---|---|---|
| 2003016759 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1417770280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7068 S OUTER 364",
"city": "O FALLON",
"state": "MO",
"postal_code": "633687757",
"telephone_number": "636-448-7868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 GARDEN BOUNTY DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633763873",
"telephone_number": "636-448-7868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JILL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-31",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2003016759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.