John E. Walz, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

21885 Issued in WI

Practice address

1511 Park Ave
Columbus, WI 53925-2401

Phone

(920) 623-3040

Fax

(920) 623-2244

NPI assigned

May 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/penob-eadbba22

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.

• Penobscot Valley Hospital

  • Critical Access Hospital
  • Lincoln, ME
  • NPI 1093716086
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225088362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539250370",
            "telephone_number": "920-623-3040",
            "fax_number": "920-623-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252401",
            "telephone_number": "920-623-3040",
            "fax_number": "920-623-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZ",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "21885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391415680019",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30477200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HERITAGE/JOHN DEERE",
            "identifier": "391415680-01",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY HEALTH PLAN",
            "identifier": "391415680-00",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "1005999",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "538607",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kevin R Wait, PT
• Walgreen Co (Walgreens #10396)
• Jean Weigand, DNP, CRNA
• Tessa Wiedmeyer, PT, DPT
• Toni Wizner, ATC
• Jacob Wochna, DO
• Angela Quinn Yamriska, RDN

• Specialist in Columbus, WI
• Providers in Columbus, WI by specialty
• Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.