Active NPI
Gary Paul Walker, O.D.
- Optometrist
- Twin Falls, ID
National Provider Identifier
1033243647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP-0539
- Practice address
- 568 Falls Ave
Twin Falls, ID 83301-3314 - Phone
- (208) 733-1944
- Fax
- (208) 734-4984
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP-0539 | ID | Primary |
Addresses
Primary practice location
568 Falls Ave
Twin Falls, ID 83301-3314
Mailing address
568 Falls Ave
Twin Falls, ID 83301-3314
Phone (208) 733-1944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002437600 | Medicaid | ID |
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 |
|---|---|---|---|
| ODP-0539 | ID | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1033243647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "568 FALLS AVE",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013314",
"telephone_number": "208-733-1944",
"fax_number": "208-734-4984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "568 FALLS AVE",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013314",
"telephone_number": "208-733-1944",
"fax_number": "208-734-4984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "GARY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP-0539",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002437600",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.