Theresa Walz, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160003831 Issued in IL

Practice address

800 E Carpenter St
Springfield, IL 62769-1000

Phone

(217) 544-6464

NPI assigned

Jun 19, 2013

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1689013088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 W URBAN ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-544-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZ",
        "first_name": "THERESA",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160003831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn M Walters, MSN, WHNP-BC
• Walton Clinic of Chiropractic Inc
• Walton Clinic, LTD
• Adrian Paul Walton, DC
• Mallory R. Waltrip, APRN
• Aiming Wang, CRNA
• Derek Wang, MD
• John Wang, DO
• Lin Wang, M.D.
• Rebecca S Wangard, NP

• Physical Therapy Assistant in Springfield, IL
• Providers in Springfield, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.