Brad Afton Walker, BS, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160-002920 Issued in IL

Practice address

13 Executive Dr
Suite 18
Fairview Heights, IL 62208-1342

Phone

(618) 624-8105

Fax

(618) 624-8214

NPI assigned

Sep 29, 2010

Last updated

Sep 29, 2010By the provider in NPPES

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 Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: brad.walker.p2@direct.athleticoltd.nextgenshare.com

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

• Boris Khariton MD PC

  • Physical Medicine & Rehabilitation Physician
  • Saint Peters, MO
  • NPI 1184847246
  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1467761148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 EXECUTIVE DR",
            "address_2": "SUITE 18",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081342",
            "telephone_number": "618-624-8105",
            "fax_number": "618-624-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 EXECUTIVE DR",
            "address_2": "SUITE 18",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081342",
            "telephone_number": "618-624-8105",
            "fax_number": "618-624-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRAD",
        "middle_name": "AFTON",
        "name_prefix": "Mr.",
        "credential": "BS, LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160-002920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Sue Voyda, FNP
• Bailey Elizabeth Wahlquist, MA
• Walgreen Co (Walgreens #04832)
• Walgreens
• Lacey Leann Walk, O.D.
• Lora L. Walker
• Benjamin Z Wallace
• Raven Ward
• Kathrine Warring, OTRL
• Jordan J Washington

• Physical Therapy Assistant in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.