Timothy O Waltner, MD

Key facts

NPI

1114084522

Entity type

Individual (NPI type 1)

Primary specialty

Diagnostic Radiology Physician 2085R0202X

License

2005010786 (MO)

Practice address

2800 Clay Edwards Dr
Kansas City, MO 64116-3220

Phone

(816) 691-5201

Fax

(816) 346-7063

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Northland Radiology, Inc. Diagnostic Radiology Physician · Kansas City, MO · NPI 1679518260
  Medicare reassignment Care Compare group NPD DIAGNOSTIC RADIOLOGY · KS · MO
• North Kansas City Hospital Community/Retail Pharmacy · North Kansas City, MO · NPI 1003381948
  NPD (past)

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New Liberty Hospital Corporation General Acute Care Hospital · Liberty, MO · NPI 1548001464
  Care Compare affiliation Hospital
• North Kansas City Hospital Skilled Nursing Facility · North Kansas City, MO · NPI 1437103215
  Care Compare affiliation Hospital
• North Kansas City Hospital General Acute Care Hospital · North Kansas City, MO · NPI 1629062799
  Care Compare affiliation Hospital
• Ray County Memorial Hospital Critical Access Hospital · Richmond, MO · NPI 1245220052
  Care Compare affiliation Hospital
• University of Kansas Hospital Authority General Acute Care Hospital · Kansas City, KS · NPI 1629369681
  Care Compare affiliation Hospital
• University of Kansas Hospital Authority General Acute Care Hospital · Kansas City, KS · NPI 1649259656
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Diagnostic Radiology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Radiology Inc (15 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• NKC Health Hospital · North Kansas City, MO · CCN 260096
• University of Kansas Hospital Hospital · Kansas City, KS · CCN 170040
• Liberty Hospital Hospital · Liberty, MO · CCN 260177
• Ray County Memorial Hospital Hospital · Richmond, MO · CCN 261327

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in MO, KS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/MtxVU3dbzZwHcvfCb2vTAE2_Nwhai9Oq/

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 3, 2014.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1114084522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419380 - DEPT 128",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641416380",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-691-5201",
            "fax_number": "816-346-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTNER",
        "first_name": "TIMOTHY",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MO",
            "license": "2005010786",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2005010786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9499055",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114084522",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200270670B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "38347013",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00397045",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Kansas City, MO · Diagnostic Radiology Physician in Missouri