Active NPI
Randal B. Walton, LMT
- Massage Therapist
- East Berlin, PA
National Provider Identifier
1689950685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG000671
- Practice address
- 663 S Kralltown Rd
East Berlin, PA 17316-9137 - Phone
- (717) 292-0304
- NPI assigned
- Oct 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MSG000671 | PA | Primary |
Addresses
Primary practice location
663 S Kralltown Rd
East Berlin, PA 17316-9137
Mailing address
663 S Kralltown Rd
East Berlin, PA 17316-9137
Phone (717) 292-0304
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 |
|---|---|---|---|
| MSG000671 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363564800000",
"number": "1689950685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "663 S KRALLTOWN RD",
"city": "EAST BERLIN",
"state": "PA",
"postal_code": "173169137",
"telephone_number": "717-292-0304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "663 S KRALLTOWN RD",
"city": "EAST BERLIN",
"state": "PA",
"postal_code": "173169137",
"telephone_number": "717-292-0304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTON",
"first_name": "RANDAL",
"middle_name": "B.",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-24",
"last_updated": "2013-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG000671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Berlin, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.