Individual provider Active NPI

James Donald Walker, DDS

  • General Practice Dentistry
  • Marion, IA
National Provider Identifier
1194045054
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08786 Issued in IA
Practice address
601 Tama St
Marion, IA 52302-4804
Phone
(319) 366-2451
NPI assigned
Jun 2, 2010
Last updated
Dec 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08786 IA Primary

Addresses

Primary practice location

601 Tama St
Marion, IA 52302-4804

Mailing address

601 Tama St
Marion, IA 52302-4804
Phone (319) 366-2451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200508000210 IA Practitioner - Dentist 5193028686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08786IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Creek Dental General Practice CurrentSince Mar 17, 2020 Accepting new patients
Thomas Grimes, DDS General Practice Past Accepting new patients

Locations

601 Tama St
Marion, IA 52302
Phone (319) 366-2451

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1194045054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TAMA ST",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523024804",
            "telephone_number": "319-366-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TAMA ST",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523024804",
            "telephone_number": "319-366-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JAMES",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IA

Sources for this page

Verify at the official NPI Registry.