Brian James Walstrom, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2014037309 Issued in MO

Practice address

8880 NE 82ND Ter
Kansas City, MO 64158-1313

Phone

(816) 437-8122

Fax

(816) 407-9609

NPI assigned

Jan 18, 2017

Sex

Male

Sole proprietor

Yes

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": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1770029449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 NE 82ND TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581313",
            "telephone_number": "816-437-8122",
            "fax_number": "816-407-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 NE 82ND TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581313",
            "telephone_number": "816-437-8122",
            "fax_number": "816-407-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSTROM",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2014037309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Mary Walsh-Kelly, M.D.
• Dexter Allen Walsh-Wiggins, RN
• Irene R Walsh, M.D.
• Lindsay Walsh
• Lauren Raeann Walski, LMSW
• Marilyn Joyce Walter, MS,LPC,ATR-BC
• Twila Jean Walter, RPSGT, CRT, CPFT
• James P. Walterbach, MD
• Alyson M Walters, LPC
• Douglas Macdowell Walters, D.D.S.

• Physical Therapy Assistant in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.