Active NPI
Brooke Walker, PTA
- Physical Therapy Assistant
- Pinellas Park, FL
National Provider Identifier
1780901504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 21344
- Practice address
- 8600 US Highway 19 N
Pinellas Park, FL 33782-5804 - Phone
- (727) 541-7515
- Fax
- (727) 545-9473
- NPI assigned
- May 4, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 21344 | FL | Primary |
Addresses
Primary practice location
8600 US Highway 19 N
Pinellas Park, FL 33782-5804
Mailing address
105 N 5TH Ave
Madill, OK 73446-1200
Phone (580) 795-3301
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 |
|---|---|---|---|
| 21344 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272931200000",
"number": "1780901504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N 5TH AVE",
"city": "MADILL",
"state": "OK",
"postal_code": "734461200",
"telephone_number": "580-795-3301",
"fax_number": "580-795-7307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 US HIGHWAY 19 N",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337825804",
"telephone_number": "727-541-7515",
"fax_number": "727-545-9473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "BROOKE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-04",
"last_updated": "2010-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "21344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinellas Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.