Active NPI
Randy D. Walker, M.D., P.L.L.C.
- Family Medicine Physician
- De Queen, AR
National Provider Identifier
1114185121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Randy Dean Walker, MD
- 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.
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Texarkana, AR
- NPI 1306230586
AR, Family Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
221 Main Ave
Dierks, AR 71833
Phone (870) 584-3000
106 N Madden St
Foreman, AR 71836
221 Main St
San Francisco, CA 94105
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FEFHCA
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
NPPES NPI RegistryPrimary 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
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145639001 | Medicaid | AR | |
| 5L991 | Other | AR | ARKANSAS BLUE CROSS AND BLUE SHIELD |
| 145640002 | Medicaid | AR |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 3, 2013.
{
"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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145639001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS BLUE CROSS AND BLUE SHIELD",
"identifier": "5L991",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145640002",
"state": "AR"
}
],
"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.