Active NPI
Michelle Wald, PTA
- Physical Therapy Assistant
- Oklahoma City, OK
National Provider Identifier
1467215772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1046
- Practice address
- 921 NE 13TH St
Oklahoma City, OK 73104-5007 - Phone
- (405) 456-2604
- NPI assigned
- Jan 31, 2024
- Last updated
- Jan 31, 2024
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 1046 | OK | Primary |
Addresses
Primary practice location
921 NE 13TH St
Oklahoma City, OK 73104-5007
Mailing address
6105 Norwich CT
Oklahoma City, OK 73132-2604
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 |
|---|---|---|---|
| 1046 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1467215772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6105 NORWICH CT",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731322604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 NE 13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045007",
"telephone_number": "405-456-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALD",
"first_name": "MICHELLE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-31",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
- Wal-Mart Stores East, LP (Walmart Vision Center 30-3430)
- Wal-Mart Stores East, LP (Walmart Vision Center 30-0564)
- Wal-Mart Stores East, LP (Walmart Vision Center 30-7326)
- Eli Walch, CRNA
- Kristen Walcher, APRN-CNS
- Julien David Waldbaum
- Jennifer Waldron, APRN
- Erick Van Waldrop, LADC/MH COUNSELOR
- Janel Waldrop, RPH
- Scott Walen, M.D., FRCSC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.