Active NPI
Walter Scott Metcalfe, MD
- Family Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1225075898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 058544
- Practice address
- 1246 Madison Ave SE
Grand Rapids, MI 49507-1761 - Phone
- (616) 913-8300
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301074613 | MI | |
| Family Medicine Physician | 207Q00000X | 058544 | GA | Primary |
Addresses
Primary practice location
1246 Madison Ave SE
Grand Rapids, MI 49507-1761
Mailing address
4959 Northside Dr
Atlanta, GA 30327-4419
Phone (770) 702-1735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231120002638 | GA | Practitioner - Family Practice | 6709889934 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058544 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Clinic Georgia LLC | Family Medicine | Past | Accepting new patients |
| Advantage Health Physicians PC | Family Medicine | Past | Accepting new patients |
| Pine Rest Christian Mental Health Services | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Grand Rapids, MI
- NPI 1386695252
-
- Professional Counselor
- Grand Rapids, MI
- NPI 1386015683
-
dba Access Medical Clinic
- Family Medicine Physician
- Perry, GA
- NPI 1730793639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569888000000",
"number": "1225075898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4959 NORTHSIDE DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303274419",
"telephone_number": "770-702-1735",
"fax_number": "770-702-1753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1246 MADISON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495071761",
"telephone_number": "616-913-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METCALFE",
"first_name": "WALTER",
"middle_name": "SCOTT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2019-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301074613",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "058544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
- Michael J. Messing, R.PH.
- Aaron Mestemaker, NP
- Stephanie Marie Meston, M.A., L.P.C.
- Zachary Buchannan Meston, LMSW, IMH-E (II)
- Met & Associates, PLC (EGR Dental)
- Jessica Anne Mete, BA
- Metro Cab of Grand Rapids
- Metron Hospice LLC
- Metropolitan Anesthesia Associates, P.C.
- Metropolitan Anesthesia Associates, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.