Individual provider Active NPI

Trent Jordan Walker, DPT

  • Physical Therapist
  • Rupert, WV
National Provider Identifier
1629643788
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003491 Issued in WV
Practice address
371 Nicholas Street
Rupert, WV 25984
Phone
(304) 661-1032
NPI assigned
May 21, 2021
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 003491 WV Primary

Addresses

Primary practice location

371 Nicholas Street
Rupert, WV 25984

Mailing address

419 High Meadows LN
Alderson, WV 24910-1170
Phone (304) 661-1032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220107000777 WV Practitioner - Physical Therapist in Private Practice 4183021447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

371 Nicholas St
Rupert, WV 25984-7703
Phone (304) 661-1032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003491WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
WV Therapy Services LLC CurrentSince Mar 1, 2022 Accepting new patients
Walker Physical Therapy LLC Physical Therapist CurrentSince May 19, 2021 Accepting new patients

Locations

415 Benedum Dr
Bridgeport, WV 26330
Phone (304) 842-9887

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1629643788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 HIGH MEADOWS LN",
            "city": "ALDERSON",
            "state": "WV",
            "postal_code": "249101170",
            "telephone_number": "304-661-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 NICHOLAS STREET",
            "city": "RUPERT",
            "state": "WV",
            "postal_code": "25984",
            "telephone_number": "304-661-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TRENT",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "003491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rupert, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.