NPIMap

Individual provider Active NPI

Walter Earl Carnahan, DO

  • Family Medicine Physician
  • Southaven, MS
National Provider Identifier
1174501449
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16014 Issued in MS
Practice address
5908 Getwell Rd
Southaven, MS 38672-7317
Phone
(662) 536-4646
Fax
(662) 536-4443
NPI assigned
Jan 5, 2006
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16014 MS Primary

Addresses

Primary practice location

5908 Getwell Rd
Southaven, MS 38672-7317

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000631 MS Practitioner - Family Practice 9537185806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Group, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

5908 Getwell Rd
Southaven, MS 38672-7317
Phone (662) 536-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16014MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group LLC Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
Family Medical Clinic of North Ms Inc Family Medicine PastSince Oct 1, 2001 Accepting new patients

Locations

7235 Hacks Cross Rd
Olive Branch, MS 38654
Phone (662) 893-7878

5908 Getwell Rd
Southaven, MS 38672
Phone (662) 536-4646

7900 Airways Blvd
Bldg A6
Southaven, MS 38671
Phone (662) 470-7554

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: wcarnahan34900@mlh.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1174501449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 GETWELL RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727317",
            "telephone_number": "662-536-4646",
            "fax_number": "662-536-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNAHAN",
        "first_name": "WALTER",
        "middle_name": "EARL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.