Walk-in Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WALK-IN CLINIC, LLC

Practice address

1516 S 31St St
Suite B
Temple, TX 76504-6752

Phone

(254) 778-6626

Fax

(254) 221-8079

NPI assigned

May 18, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Rayburn Wesley Mitchum III, B.S.

Title

Director of Business Development

Phone

(936) 553-3417

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kassey Burney

  • Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1457809949
  Medicare reassignment NPD
• Bridget Y Hughes, FNP

  • Family Nurse Practitioner
  • Center, TX
  • NPI 1881785251
  Medicare reassignment NPD
• Carl Austin Willeford Jr., FNP-C

  • Family Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1063465409
  Medicare reassignment NPD
• Courtney Avra, PA

  • Physician Assistant
  • Nacogdoches, TX
  • NPI 1194485375
  NPD (past)
• Richard Lynn Baker, MD

  • Internal Medicine Physician
  • Nacogdoches, TX
  • NPI 1538185517
  NPD (past)
• Bryan W Davis, M.D.

  • Family Medicine Physician
  • Nacogdoches, TX
  • NPI 1295760080
  NPD (past)

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1033566286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633821",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759633821",
            "telephone_number": "936-564-7373",
            "fax_number": "936-564-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 S 31ST ST",
            "address_2": "SUITE B",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765046752",
            "telephone_number": "254-778-6626",
            "fax_number": "254-221-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALK-IN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "MITCHUM",
        "authorized_official_first_name": "RAYBURN",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "936-553-3417",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LLC
• Wal-Mart Stores Texas, LP
• Walgreen Co
• Walgreen Co
• Sarah E Walker-Ennis
• Carolyn H Walker, PT MS
• Douglas W Walker, PA
• Jaitavia N Walker
• Kim L. Walker, M.D.

• Family Medicine Physician in Temple, TX
• Providers in Temple, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.