Individual provider Active NPI

David Michael Walters, MD

  • Otolaryngology Physician
  • Birmingham, AL
National Provider Identifier
1093938615
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
28192 Issued in AL
Practice address
1809 Gadsden Hwy
Birmingham, AL 35235-3134
Phone
(205) 838-3755
Fax
(205) 838-3755
NPI assigned
Apr 11, 2007
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 076531 GA
Otolaryngology Physician 207Y00000X 28192 AL Primary

Addresses

Primary practice location

1809 Gadsden Hwy
Birmingham, AL 35235-3134

Mailing address

1809 Gadsden Hwy
Birmingham, AL 35235-3134
Phone (706) 320-3128

Other identifiers 2

IdentifierTypeStateIssuer
000060077MedicaidAL
051559827MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000422 AL Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 2860586211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern ENT and Sinus Center PCGroup PAC ID 8729008388, 3 clinicians

Practice addresses (Care Compare)

1809 Gadsden Hwy
Birmingham, AL 35235-3134
Phone (205) 838-3755

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern ENT & Sinus Center, P.C. Otolaryngology CurrentSince Sep 1, 2018 Accepting new patients
Alabama Orthopedic Spine & Sports Medicine Associates P C PastSince Jul 25, 2021 Accepting new patients

Locations

1809 Gadsden Hwy
Birmingham, AL 35235
Phone (205) 838-3744

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1093938615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 GADSDEN HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353134",
            "telephone_number": "706-320-3128",
            "fax_number": "706-320-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 GADSDEN HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353134",
            "telephone_number": "205-838-3755",
            "fax_number": "205-838-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "076531",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "28192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060077",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051559827",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.