Tommy Otis Walker, B.A.

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

11565 Laurel Canyon Blvd Ste 218
San Fernando, CA 91340-4652

Phone

(818) 901-8985

NPI assigned

Jun 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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.

• Corrections and Rehabilitation-Headquarters

  dba Department of Pharmacy California State Prison LA County

  • Pharmacy
  • Lancaster, CA
  • NPI 1558996371
  NPD (past)

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1447810700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 W 36TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900183941",
            "telephone_number": "323-632-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 LAUREL CANYON BLVD STE 218",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404652",
            "telephone_number": "818-901-8985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44750 60th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935367619",
            "country_code": "US",
            "telephone_number": "661-729-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TOMMY",
        "middle_name": "OTIS",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Practitioner in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.