Jacob Ryan Walker, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299190 Issued in CA

Practice address

7060 N Durango Dr Ste 130
Las Vegas, NV 89149-4605

Phone

(702) 826-5749

Fax

(702) 273-3015

NPI assigned

Sep 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1699382515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 STAGS LEAP DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231166221",
            "telephone_number": "804-971-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7060 N DURANGO DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494605",
            "telephone_number": "702-826-5749",
            "fax_number": "702-273-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 N Crawford St",
            "address_purpose": "LOCATION",
            "city": "Willows",
            "state": "CA",
            "postal_code": "959882326",
            "country_code": "US",
            "telephone_number": "530-934-2834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213694",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gesiel Walker
• Gregory Walker
• Gwendolyn Latonya Walker
• Hayden Walker
• Ivie Walker
• Jacqueline Garalde Walker, FNP
• Jacqueline Renae Walker
• James Walker Jr.
• Jaren Walker
• Jasmyne Walker

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.