Active NPI
Walter Hancock DPM PC
- Podiatrist
- Evansville, IN
National Provider Identifier
1093869612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 07000330
- Legal business name
- WALTER HANCOCK DPM PC
- Practice address
- 2042 Lincoln Ave
Evansville, IN 47714-1561 - Phone
- (812) 477-1821
- Fax
- (812) 475-0327
- NPI assigned
- Jan 22, 2007
- Organization subpart
- Yes
- Parent organization
- WALTER HANCOCK DPM PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Walter Hancock, DPM
- Title
- DPM
- Phone
- (812) 477-1821
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07000330 | IN | Primary |
Addresses
Primary practice location
2042 Lincoln Ave
Evansville, IN 47714-1561
Mailing address
2042 Lincoln Ave
Evansville, IN 47714-1561
Phone (812) 477-1821
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000042449 | Other | IN | ANTHEM BLUE SHEILD |
| 100110420 A & B | Medicaid | IN | |
| 000000108408 | Other | IN | ANTHEM BLUE SHEILD |
| 480068075 A | Other | IN | PALMETTO MEDICARE |
| 0243760002 | Other | IN | MEDICARE DME |
National Provider Directory
National Provider Directory- Part of
- Walter Hancock DPM PC
Locations
2042 Lincoln Ave
Evansville, IN 47714
Phone (812) 477-1821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1308268800000",
"number": "1093869612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2042 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477141561",
"telephone_number": "812-477-1821",
"fax_number": "812-475-0327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2042 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477141561",
"telephone_number": "812-477-1821",
"fax_number": "812-475-0327"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALTER HANCOCK DPM PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALTER HANCOCK DPM PC",
"enumeration_date": "2007-01-22",
"last_updated": "2011-06-17",
"status": "A",
"authorized_official_last_name": "HANCOCK",
"authorized_official_first_name": "WALTER",
"authorized_official_title_or_position": "DPM",
"authorized_official_telephone_number": "812-477-1821",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "IN",
"license": "07000330",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHEILD",
"identifier": "000000042449",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100110420 A & B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHEILD",
"identifier": "000000108408",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO MEDICARE",
"identifier": "480068075 A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DME",
"identifier": "0243760002",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.