NPIMap

Organization Active NPI

Randy D. Walker, M.D., P.L.L.C.

  • Family Medicine Physician
  • De Queen, AR
National Provider Identifier
1114185121
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RANDY D. WALKER, M.D., P.L.L.C.
Practice address
1553 W Collin Raye Dr
De Queen, AR 71832-3801
Phone
(870) 584-3000
Fax
(870) 584-3003
NPI assigned
May 27, 2008
Last updated
Sep 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Dr. Randy Dean Walker, MDNPI 1730185752
Title
Owner
Phone
(870) 584-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1553 W Collin Raye Dr
De Queen, AR 71832-3801

Mailing address

PO Box 740
De Queen, AR 71832-0740
Phone (870) 584-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140826002759 AR Part B Supplier - Clinic/Group Practice 0345468724 Receives reassigned benefits from 13 practitioners
Practice locations: De Queen, AR; Dierks, AR

National Provider Directory

National Provider Directory

Locations

221 Main Ave
Dierks, AR 71833
Phone (870) 584-3000

221 Main St
San Francisco, CA 94105

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEFHCA

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1114185121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718320740",
            "telephone_number": "870-584-3000",
            "fax_number": "870-584-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 W COLLIN RAYE DR",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718323801",
            "telephone_number": "870-584-3000",
            "fax_number": "870-584-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY D. WALKER, M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-584-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Queen, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.