Active NPI
Joseph R Walker, M.D.
- Neurological Surgery Physician
- Reno, NV
National Provider Identifier
1063419554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 3369
- Practice address
- 5590 Kietzke LN
Reno, NV 89511-3019 - Phone
- (775) 323-2080
- Fax
- (775) 325-2334
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 3369 | NV | Primary |
Addresses
Primary practice location
5590 Kietzke LN
Reno, NV 89511-3019
Mailing address
5590 Kietzke LN
Reno, NV 89511-3019
Phone (775) 323-2080
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002016247 | Medicaid | NV | |
| CC3369 | Other | NV | BLUE CROSS BLUE SHIELD |
| 880167036A012 | Other | NV | TRICARE |
| FS49001151 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3369 | NV | MD | Neurological Surgery Physician |
Interoperability endpoints
- https://api.platform.athenahealth.com/13729/brand/6/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1063419554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5590 KIETZKE LN",
"city": "RENO",
"state": "NV",
"postal_code": "895113019",
"telephone_number": "775-323-2080",
"fax_number": "775-325-2334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5590 KIETZKE LN",
"city": "RENO",
"state": "NV",
"postal_code": "895113019",
"telephone_number": "775-323-2080",
"fax_number": "775-325-2334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JOSEPH",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NV",
"license": "3369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002016247",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "CC3369",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "880167036A012",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FS49001151",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.