Active NPI
Susan L Walker, R.N., L.M.T.
- Massage Therapist
- Windham, ME
National Provider Identifier
1649417007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT669
- Practice address
- 456 Roosevelt TRL
Windham, ME 04062-6918 - Phone
- (207) 893-2310
- NPI assigned
- Jan 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R021052 | ME | |
| Massage Therapist | 225700000X | MT669 | ME | Primary |
Addresses
Primary practice location
456 Roosevelt TRL
Windham, ME 04062-6918
Mailing address
456 Roosevelt TRL
Windham, ME 04062-6918
Phone (207) 893-2310
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R021052 | ME | MD | Registered Nurse |
| MT669 | ME | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1649417007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "456 ROOSEVELT TRL",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040626918",
"telephone_number": "207-893-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 ROOSEVELT TRL",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040626918",
"telephone_number": "207-893-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "R.N., L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ME",
"license": "R021052",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ME",
"license": "MT669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.