Active NPI
Emily Marie Walden
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1942583836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05003230A
- Practice address
- 3512 Stellhorn Rd
Fort Wayne, IN 46815-4631 - Phone
- (260) 483-9081
- Fax
- (260) 483-9196
- NPI assigned
- Sep 27, 2011
- Last updated
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 05003230A | IN | Primary |
Addresses
Primary practice location
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Mailing address
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone (260) 483-9081
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05003230A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1942583836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 STELLHORN RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468154631",
"telephone_number": "260-483-9081",
"fax_number": "260-483-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 STELLHORN RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468154631",
"telephone_number": "260-483-9081",
"fax_number": "260-483-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDEN",
"first_name": "EMILY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-27",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05003230A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
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- Wal-Mart Stores East, LP (Vision Center 30-1419)
- Wal-Mart Stores East, LP (Vision Center 30-1804)
- Leslie Ann Waldo, NP
- Emily Waldron, NP
- Walgreen Co (Walgreens #6868)
- Walgreen Co (Walgreens #11945)
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.