Individual provider Active NPI

Kimberly Nicole Walker, OTD

  • Gerontology Occupational Therapist
  • Bowling Green, KY
National Provider Identifier
1750855904
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
163996 Issued in KY
Practice address
5079 Scottsville Rd
Bowling Green, KY 42104-7897
Phone
(270) 781-2462
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 163996 KY Primary

Addresses

Primary practice location

5079 Scottsville Rd
Bowling Green, KY 42104-7897

Mailing address

5079 Scottsville Rd
Bowling Green, KY 42104-7897

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

LicenseStateTypeSpecialty
163996KYMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1750855904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5079 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5079 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047897",
            "telephone_number": "270-781-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "KY",
            "license": "163996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.