John a Walsh MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME78805 Issued in FL

Legal business name

JOHN A WALSH MD PA

Practice address

14 Office Park Dr Ste 7
Palm Coast, FL 32137-3830

Phone

(386) 302-5064

Fax

(386) 302-5093

NPI assigned

May 25, 2006

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Alan Walsh, MDNPI 1932271541

Title

President

Phone

(386) 328-0245

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12685/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Alan Walsh, MD

  • Vascular Surgery Physician
  • Palm Coast, FL
  • NPI 1932271541
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1275589152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17021",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154065",
            "telephone_number": "386-302-5064",
            "fax_number": "386-302-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 OFFICE PARK DR STE 7",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373830",
            "telephone_number": "386-302-5064",
            "fax_number": "386-302-5093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Zeagler Dr",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321776855",
            "country_code": "US",
            "telephone_number": "386-328-0245",
            "fax_number": "386-328-8510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN A WALSH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-328-0245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME78805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110996800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q0466",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milena Jguenti, MD
• Summer Jiloty
• Molly E Jimenez, ARNP
• Uzziel Jivcu, ARNP
• Harold Johanessen Jr., BCBA
• John G Symeonides M D LLC
• Johnny Bernard Jr MD LLC
• Jeanette Deloris Johnson
• Katherine Anne Johnson
• Lisa Johnson, LCSW

• Specialist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.