Clarence William Walker, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0123 Issued in MN

Practice address

17 Ash Street, N.E
Post Office Box 92
New London, MN 56273

Phone

(320) 354-4489

Fax

(320) 354-4490

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Dr. C. William Walker Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Affiliated Community Medical Centers, LTD

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1952363699
  NPD
• Carris Health LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1598236408
  NPD
• Interventional Pain & Physical Medicine Clinic

  • Pain Clinic/Center
  • Sartell, MN
  • NPI 1013056969
  NPD
• Interventional Pain & Physical Medicine Clinic

  • Durable Medical Equipment & Medical Supplies
  • Sartell, MN
  • NPI 1710230800
  NPD
• Knutson Counseling & Seminars, Inc.

  • Mental Health Counselor
  • Willmar, MN
  • NPI 1568784668
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1053481069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PINE ST., NW",
            "address_2": "C. WILLIAM WALKER, PH.D.",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "320-354-4489",
            "fax_number": "320-354-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ASH STREET, N.E",
            "address_2": "POST OFFICE BOX 92",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "320-354-4489",
            "fax_number": "320-354-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CLARENCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "C1083",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0321",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "LICSW06609",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843748300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C. WILLIAM",
            "last_name": "WALKER",
            "prefix": "DR.",
            "credential": "PHD.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tessa Maline Slinden, PA-C
• Thomas Allen Sult, MD
• Summit Health Solutions
• Heather Van Beck
• Amber O Vick, MD
• Richard A Wehseler, MD
• Susan Jacobs Werner, OTR/L
• Willow Creek Counseling LLC
• Donald Michael Zieske, D.C.

• Psychologist in New London, MN
• Providers in New London, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.