Walter D Merritt III, M.D.

Primary specialty

Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X

License

M5753 Issued in ID

Practice address

8185 State Highway 789
Lander, WY 82520-2942

Phone

(307) 335-7555

Fax

(307) 335-7999

NPI assigned

Nov 28, 2005

Last updated

Sep 11, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northern Itasca Hospital District

  dba Bigfork Valley Hospital

  • Critical Access Hospital
  • Bigfork, MN
  • NPI 1851335525
  Medicare reassignment NPD
• Fremont Ear Nose and Throat

  • Otolaryngology Physician
  • Lander, WY
  • NPI 1396976577
  Authorized official Same address or phone
• Northern Itasca Hospital District

  dba Bigfork Valley Communities

  • Skilled Nursing Facility
  • Bigfork, MN
  • NPI 1831133990
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1053394643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8185 STATE HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202942",
            "telephone_number": "307-335-7555",
            "fax_number": "307-335-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8185 STATE HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202942",
            "telephone_number": "307-335-7555",
            "fax_number": "307-335-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "WALTER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "ID",
            "license": "M5753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804259200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinton McMahill, M.D.
• Patti J McMahon, LPC
• McRae Inc
• Laurie Ann Meeks
• Clinton Franklin Merrill Jr., M.D.
• Jacqueline A Meyer, FNP
• Mel R Meyer, MD
• Michael G Shane DDS PC
• Michael Pryor, M.D., P.C.
• Claude Barrett Minor, M.D.

• Otolaryngology Physician in Lander, WY
• Providers in Lander, WY by specialty
• Otolaryngology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.