Karyn Leslie Walters, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

116816 Issued in MO

Practice address

29612 Kellogg Ave
Macon, MO 63552-3702

Phone

(660) 385-5797

Fax

(660) 385-1301

NPI assigned

Aug 23, 2007

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

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1558554592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E PIERCE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013643",
            "telephone_number": "660-385-1307",
            "fax_number": "660-385-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29612 KELLOGG AVE",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635523702",
            "telephone_number": "660-385-5797",
            "fax_number": "660-385-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "KARYN",
        "middle_name": "LESLIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "116816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Lee Taylor, PHARM D
• Matthew Theriac, D.D.S.
• Thomas Thurman, D.C.
• Vision Care Associates, LLC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0783)
• Lacey Chantelle Watts
• Chelsea Lynn Wells, LMSW
• Clayton Earl Whetmore, D.O.
• Robert Mayo Wilhite, D.D.S.
• Tamara Lynn Wilhoit, R.PH.

• Physical Therapy Assistant in Macon, MO
• Providers in Macon, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.