Individual provider Active NPI

Tamnika Nicole Walton

  • Social Worker
  • Fort Worth, TX
National Provider Identifier
1972255453
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
106366 Issued in TX
Practice address
6115 Camp Bowie Blvd Ste 220
Fort Worth, TX 76116-5543
Phone
(682) 268-1510
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X TX
Social Worker 104100000X 106366 TX Primary

Addresses

Primary practice location

6115 Camp Bowie Blvd Ste 220
Fort Worth, TX 76116-5543

Mailing address

2305 Wimbledon Dr
Arlington, TX 76017-3725
Phone (817) 917-2188

Other practice location 1

555 Mission St
San Francisco, CA 94105-0920
Phone (415) 403-2156

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
106366TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1972255453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 WIMBLEDON DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760173725",
            "telephone_number": "817-917-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 CAMP BOWIE BLVD STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165543",
            "telephone_number": "682-268-1510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941050920",
            "country_code": "US",
            "telephone_number": "415-403-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "TAMNIKA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "106366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.