Kristy Marie Wall, MASSAGE THERAPIST

Primary specialty

NaturopathTaxonomy code 175F00000X

License

173821 Issued in OK

Practice address

6221 SE 15TH St
Midwest City, OK 73110-2623

Phone

(206) 380-9118

NPI assigned

Sep 7, 2021

Last updated

Sep 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1487323143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 SE 15TH ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731102623",
            "telephone_number": "206-380-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 SE 15TH ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731102623",
            "telephone_number": "206-380-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KRISTY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OK",
            "license": "173821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "173821",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #09223)
• Walgreen Co (Walgreens #05967)
• Shirley Walker-Mitchell, BHRS
• Makayla Walker, PT / US
• Shelbie Walker
• Emily Walls
• John D Walsh, M.D.
• Kaubriana S Walter
• Speshial Tynese Walters
• Shuree Dawn Walton-Lane

• Naturopath in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Naturopath in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.