Glenn W Walter, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

AA316 Issued in FL

Practice address

502 West Highland Blvd
Inverness, FL 34452-4720

Phone

(352) 726-1551

NPI assigned

Oct 15, 2015

Last updated

Dec 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

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

• Indian River Health Services Inc

  dba Behavioral Health Center

  • Psychiatry Physician
  • Vero Beach, FL
  • NPI 1710933031
  Medicare reassignment Care Compare group NPD
• Indian River Health Services Inc

  dba Irhs-Cardiology North

  • Cardiovascular Disease Physician
  • Sebastian, FL
  • NPI 1659651990
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indian River Memorial Hospital Inc

  dba Cleveland Clinic Indian River Hospital

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988
  Care Compare affiliation

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1013388164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N. HARRISON PARKWAY",
            "address_2": "SUITE 200, MAILSTOP SH-9A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 WEST HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524720",
            "telephone_number": "352-726-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "GLENN",
        "middle_name": "W",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-1104)
• Wal-Mart Stores East, LP (Vision Center 30-1104)
• Walgreen Co (Walgreens #05691)
• Dennis J Walker, MD
• Lydia Valladares Wallace, D.O.
• Tzirel Ward, DO
• Rachelle Warden
• Lane Wardrop
• Sharon Washington, MSW
• James Robert Watt, D.O.

• Anesthesiologist Assistant in Inverness, FL
• Providers in Inverness, FL by specialty
• Anesthesiologist Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.