Active NPI
Kristen Nicole Walls, OT
- Occupational Therapist
- Hernando, MS
National Provider Identifier
1427497627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT2815
- Practice address
- 190 W South St
Hernando, MS 38632-2245 - Phone
- (662) 298-0066
- NPI assigned
- Jun 20, 2013
- Last updated
- Jun 20, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT2815 | MS | Primary |
Addresses
Primary practice location
190 W South St
Hernando, MS 38632-2245
Mailing address
2284 Fogg Rd
Nesbit, MS 38651-7409
Phone (662) 404-0425
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 |
|---|---|---|---|
| OT2815 | MS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1427497627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2284 FOGG RD",
"city": "NESBIT",
"state": "MS",
"postal_code": "386517409",
"telephone_number": "662-404-0425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 W SOUTH ST",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386322245",
"telephone_number": "662-298-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "KRISTEN",
"middle_name": "NICOLE",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-20",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT2815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hernando, MS
- Amy Robertson Wadsworth, D.D.S.
- William Manley Wadsworth, M.D.
- Wal-Mart Stores East LP (Walmart Pharmacy 10-5419)
- Wal-Mart Stores East, LP (Vision Center 30-5419)
- Walgreen Co (Walgreens # 10706)
- Jenevieve Lynn Wardell, LPC-S
- Malinda Renee Watson, SLP
- Weaver Clinic, LLC
- Callissa L. Wells
- Sherika Lashea Wheeler, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.