Emerson Bertram Walls, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A5923 Issued in CA

Practice address

1300 N Fresno St
Fresno, CA 93703-3845

Phone

(559) 495-6758

Fax

(559) 495-6784

NPI assigned

Mar 7, 2007

Last updated

Jun 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Sanger Pediatrics a Medical Corporation

  • Health Service Clinic/Center
  • Sanger, CA
  • NPI 1245309772
  NPD (past) Authorized official
• Fresno Community Hospital and Medical Center

  dba Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1073643920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033845",
            "telephone_number": "559-495-6758",
            "fax_number": "559-495-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033845",
            "telephone_number": "559-495-6758",
            "fax_number": "559-495-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "EMERSON",
        "middle_name": "BERTRAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A5923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO LICENSE",
            "identifier": "20A5923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corenna Louise Waller
• Maggie Reed Walley, MT-BC
• Tamera Walley, PT
• David Wallick
• Sherry Muterspaugh Walling, PH.D.
• Walmart Inc. (Walmart Pharmacy 10-2001)
• Walmart Inc. (WalMart Pharmacy 10-2689)
• Walmart Inc. (WalMart Pharmacy 10-5634)
• Walmart Inc. (Walmart Pharmacy 10-2985)
• Walmart Inc. (Walmart Pharmacy 10-5632)

• Pediatrics Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.