J Walden Retan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3223 Issued in AL

Practice address

177 Oak Ridge LN
Talladega, AL 35160-8303

Phone

(205) 266-4928

NPI assigned

Nov 25, 2006

Last updated

Feb 5, 2013By 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 2

Addresses

Other identifiers 1

Other names 1

• John W Retan Other name

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Cooper Green Mercy Health Services Authority an Affiliate of Uab

  • Clinic/Center
  • Birmingham, AL
  • NPI 1366073108
  Medicare reassignment NPD
• Cooper Green Mercy Health Services Authority an Affiliate of Uab

  dba Cooper Green Clinic Pharmacy

  • Clinic Pharmacy
  • Birmingham, AL
  • NPI 1568081644
  NPD

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

{
    "created_epoch": "1164412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1225104094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 OAK RIDGE LN",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351608303",
            "telephone_number": "205-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 OAK RIDGE LN",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351608303",
            "telephone_number": "205-266-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETAN",
        "first_name": "J",
        "middle_name": "WALDEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-25",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "3223",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "3223",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5241",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "RETAN",
            "middle_name": "W",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Quality of Life Health Services, Inc
• Rai Care Centers of Alabama LLC
• Regional Health Management Corporation (Talladega Primary and Urgent Care Center)
• Rehab and Wellness Clinic, LLC
• Renal Treatment Centers-Southeast, LP. (Talladega Dialysis)
• Latecia Elston Rhoden, AGACRNP-BC
• Rite Aid
• Robert Heuermann MD LLC
• David H Roberts, M.D.
• Crystal Renee Rogers, CRNP

• Internal Medicine Physician in Talladega, AL
• Providers in Talladega, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.

Verify at the official NPI Registry.