Matthew Walters

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

121 University Dr N
Fargo, ND 58102-4631

Phone

(218) 593-1694

NPI assigned

Feb 19, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwest Mental Health Clinic PLLC

  • Addiction (Substance Use Disorder) Counselor
  • Fargo, ND
  • NPI 1710600028
  NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1245095264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 UNIVERSITY DR N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024631",
            "telephone_number": "218-593-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 UNIVERSITY DR N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024631",
            "telephone_number": "218-593-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Waller Waller
• Walman Optical Company
• John Walsh, MD
• Corey William Walters
• Kaitlin Jo Walters, APRN
• Rebecca Jo Walters
• Corey Walther
• Kylie Melissa Walthers, OTR/L
• Walton Chiropractic Clinic P.C.
• Stephen C Walton, DC

• All providers in Fargo, ND
• Case Manager/Care Coordinator in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.