Individual provider Active NPI

Andrew Oxley Walters, OT

  • Occupational Therapist
  • Folsom, CA
National Provider Identifier
1790942563
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2884 Issued in CA
Practice address
1301 E Bidwell St
201
Folsom, CA 95630-3452
Phone
(916) 983-5915
Fax
(916) 983-5925
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2884 CA Primary

Addresses

Primary practice location

1301 E Bidwell St
201
Folsom, CA 95630-3452

Mailing address

1301 E Bidwell St
201
Folsom, CA 95630-3452
Phone (916) 983-5915

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
2884CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1790942563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL ST",
            "address_2": "201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303452",
            "telephone_number": "916-983-5915",
            "fax_number": "916-983-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL ST",
            "address_2": "201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303452",
            "telephone_number": "916-983-5915",
            "fax_number": "916-983-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ANDREW",
        "middle_name": "OXLEY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "2884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.