Individual provider Active NPI

James Edward Walsh, DPM

  • Podiatrist
  • Rio Grande, NJ
National Provider Identifier
1205943305
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD00001234 Issued in NJ
Practice address
1078 RT 47 South
Rio Grande, NJ 08242-1608
Phone
(609) 886-3737
Fax
(609) 886-1854
NPI assigned
Aug 24, 2006
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD00001234 NJ Primary

Addresses

Primary practice location

1078 RT 47 South
Rio Grande, NJ 08242-1608

Mailing address

1078 RT 47 South
Rio Grande, NJ 08242-1608
Phone (609) 886-3737

Other identifiers 1

IdentifierTypeStateIssuer
225405MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100916000849 NJ Practitioner - Podiatry 1850416629 Practice locations: Rio Grande, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD00001234NJMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1205943305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 RT 47 SOUTH",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421608",
            "telephone_number": "609-886-3737",
            "fax_number": "609-886-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 RT 47 SOUTH",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421608",
            "telephone_number": "609-886-3737",
            "fax_number": "609-886-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD00001234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, NJ

Sources for this page

Verify at the official NPI Registry.