Richard Walter, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

02000873 Issued in IN

Practice address

1813 Willow St
Suite 5 B
Vincennes, IN 47591-4267

Phone

(812) 882-2703

Fax

(812) 882-2760

NPI assigned

Jul 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: richard.walter.1@21022.direct.athenahealth.com

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1114927886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 WILLOW ST",
            "address_2": "SUITE 5 B",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914267",
            "telephone_number": "812-882-2703",
            "fax_number": "812-882-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 WILLOW ST",
            "address_2": "SUITE 5 B",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914267",
            "telephone_number": "812-882-2703",
            "fax_number": "812-882-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "RICHARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "02000873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100427420",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000847454",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.