Individual provider Active NPI

Nicole Walsh

  • Occupational Therapist
  • Louisville, KY
National Provider Identifier
1962274316
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
288723 Issued in KY
Practice address
1901 Commonwealth CT Unit B
Louisville, KY 40299-2355
Phone
(502) 599-0033
NPI assigned
Oct 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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 288723 KY Primary

Addresses

Primary practice location

1901 Commonwealth CT Unit B
Louisville, KY 40299-2355

Mailing address

1901 Commonwealth CT
Louisville, KY 40299-2355
Phone (502) 599-0033

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
288723KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Therapy, PLLC Occupational Therapist CurrentSince Oct 29, 2023 Accepting new patients

Locations

1901 Commonwealth Ct
#B
Louisville, KY 40299
Phone (502) 458-9978

1901 Commonwealth Ct
Louisville, KY 40299
Phone (502) 458-9978

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1962274316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 COMMONWEALTH CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992355",
            "telephone_number": "502-599-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 COMMONWEALTH CT UNIT B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992355",
            "telephone_number": "502-599-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "288723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.