Active NPI
Shelly M Walsh, PT
- Physical Therapist
- Kokomo, IN
National Provider Identifier
1619061983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05006282A
- Practice address
- 1226 E Hoffer St
Kokomo, IN 46902-5727 - Phone
- (765) 868-4686
- Fax
- (765) 868-4691
- NPI assigned
- Oct 3, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05006282A | IN | Primary |
Addresses
Primary practice location
1226 E Hoffer St
Kokomo, IN 46902-5727
Mailing address
1220 Laguna St
Kokomo, IN 46902-2330
Phone (765) 454-5340
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 |
|---|---|---|---|
| 05006282A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619061983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 LAGUNA ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469022330",
"telephone_number": "765-454-5340",
"fax_number": "765-454-5347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1226 E HOFFER ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469025727",
"telephone_number": "765-868-4686",
"fax_number": "765-868-4691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "SHELLY",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05006282A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.