Individual provider Active NPI

Walter Hargett, MD

  • Family Medicine Physician
  • Neosho, MO
National Provider Identifier
1053352773
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R4D90 Issued in MO
Practice address
2550 Lusk Dr
Neosho, MO 64850-8855
Phone
(417) 451-2060
Fax
(417) 451-6214
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R4D90 MO Primary

Addresses

Primary practice location

2550 Lusk Dr
Neosho, MO 64850-8855

Mailing address

2550 Lusk Dr
Neosho, MO 64850-8855
Phone (417) 451-2060

Other identifiers 2

IdentifierTypeStateIssuer
200207220AMedicaidOK
203466727MedicaidMO

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sjmgroup PastSince Jun 13, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: whargett190708@directb.mercy.net

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1053352773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508855",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508855",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGETT",
        "first_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R4D90",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200207220A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203466727",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.