Individual provider Active NPI

Walton Rice, OD

  • Optometrist
  • Woodbridge, VA
National Provider Identifier
1053419358
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001055 Issued in VA
Practice address
2700 Potomac Mills Cir Ste 105
Woodbridge, VA 22192-4651
Phone
(703) 494-0660
Fax
(703) 497-4605
NPI assigned
Sep 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001055 VA Primary

Addresses

Primary practice location

2700 Potomac Mills Cir Ste 105
Woodbridge, VA 22192-4651

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080903000104 DC Practitioner - Optometry 9335215185 Reassigns benefits to 1 organization
I20260224003650 VA Practitioner - Optometry 9335215185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1574 Sandpiper Bay Loop
Dumfries, VA 22026-2982

19100 Ridgewood Pkwy
San Antonio, TX 78259-1828

19100 Ridgewood Pkwy
BLDG 1 7TH Floor
San Antonio, TX 78259-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001055VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jan 20, 2026 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jan 20, 2026 Accepting new patients

Locations

11130L South Lakes Dr
Reston, VA 20191
Phone (703) 471-1012

8359 Leesburg Pike
Vienna, VA 22182
Phone (703) 442-9285

2700 Potomac Mills Cir
Ste 105
Woodbridge, VA 22192
Phone (703) 494-0660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053419358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 POTOMAC MILLS CIR STE 105",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924651",
            "telephone_number": "703-494-0660",
            "fax_number": "703-497-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "WALTON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.