Active NPI
Dewayne Edward Waltz, LMSW
- Social Worker
- Chillicothe, OH
National Provider Identifier
1225276231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 52318
- Practice address
- 17273 State Route 104
Chillicothe, OH 45601-8608 - Phone
- (740) 779-1141
- Fax
- (740) 772-7077
- NPI assigned
- Jan 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 52318 | TX | Primary |
Addresses
Primary practice location
17273 State Route 104
Chillicothe, OH 45601-8608
Mailing address
17273 State Route 104
Chillicothe, OH 45601-8608
Phone (740) 779-1141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52318 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1225276231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456018608",
"telephone_number": "740-779-1141",
"fax_number": "740-772-7077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456018608",
"telephone_number": "740-779-1141",
"fax_number": "740-772-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTZ",
"first_name": "DEWAYNE",
"middle_name": "EDWARD",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "52318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.