Audrea Deshon Walker, MASSAGE THERPAIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT000792 Issued in GA

Practice address

3115 Piedmont Rd NE Ste D102
Atlanta, GA 30305-2521

Phone

(404) 969-2374

NPI assigned

Nov 14, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1487299434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 OAKLEY RD APT 1507",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302911582",
            "telephone_number": "678-754-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 PIEDMONT RD NE STE D102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052521",
            "telephone_number": "404-969-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "AUDREA",
        "middle_name": "DESHON",
        "credential": "MASSAGE THERPAIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT000792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO OTHER NUMBERS",
            "identifier": "MT000792",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "crystalsoundbody.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "3115 Piedmont Rd NE Ste D102",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303052521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allegra Renee Crews Walker, MSN APRN CNM
• Amanda Kristin Walker
• Angela Walker, S/T
• Antiqua Walker
• Atarah Walker
• Bruce F Walker, MD
• Caroline Elizabeth Walker
• Casy Walker, M.ED., CCC-SLP
• Cecil Walker, LMFT
• Chaun Walker

• Massage Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.