Active NPI
Laura Walker
- Pediatric Occupational Therapist
- Destin, FL
National Provider Identifier
1558743567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT 17142
- Practice address
- 4300 Legendary Dr
Suite 208
Destin, FL 32541-8604 - Phone
- (504) 274-9544
- Fax
- (850) 460-8703
- NPI assigned
- Jun 25, 2015
- Last updated
- Jun 26, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT 17142 | FL | Primary |
Addresses
Primary practice location
4300 Legendary Dr
Suite 208
Destin, FL 32541-8604
Mailing address
4300 Legendary Dr
Suite 208
Destin, FL 32541-8604
Phone (504) 274-9544
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 |
|---|---|---|---|
| OT 17142 | FL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435276800000",
"number": "1558743567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 LEGENDARY DR",
"address_2": "SUITE 208",
"city": "DESTIN",
"state": "FL",
"postal_code": "325418604",
"telephone_number": "504-274-9544",
"fax_number": "850-460-8703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 LEGENDARY DR",
"address_2": "SUITE 208",
"city": "DESTIN",
"state": "FL",
"postal_code": "325418604",
"telephone_number": "504-274-9544",
"fax_number": "850-460-8703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-25",
"last_updated": "2015-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT 17142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destin, FL
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- Jennifer Wallace, PHARM.D.
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- Patricia Walsh, LCSW
- Asher Zaslaw Ward, LCSW
- James William Ward Jr., MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.