Derek Alan Walton, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

413T Issued in WY

Practice address

400 E Adams Ave
Riverton, WY 82501-4413

Phone

(307) 856-3937

Fax

(307) 856-1306

NPI assigned

Oct 7, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hometown Eyecare and OpticalGroup PAC ID 7416222781, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

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.

• Hometown Eyecare and Optical

  • Optometrist
  • Riverton, WY
  • NPI 1730608860
  Medicare reassignment Care Compare group NPD Authorized official
• Kister Eyecare, PC

  • Optometrist
  • Riverton, WY
  • NPI 1700055951
  NPD

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295019339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E ADAMS AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825014413",
            "telephone_number": "307-856-3937",
            "fax_number": "307-856-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ADAMS AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825014413",
            "telephone_number": "307-856-3937",
            "fax_number": "307-856-1306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 N Main St",
            "address_purpose": "LOCATION",
            "city": "Spanish Fork",
            "state": "UT",
            "postal_code": "846601150",
            "country_code": "US",
            "telephone_number": "801-798-3557",
            "fax_number": "801-798-1182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "DEREK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "8527006-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "413T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U000078885",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessika Ruth Waldron
• Walgreen Co
• Brenda Jo Walker, OTR/L
• Megan Walls, DC
• Walmart Inc.
• Gabriella Ward
• Mallory Ward, DPT
• Olivia P Washington, RN
• Sharmaine Loveli Weed
• Western Family Care

• Optometrist in Riverton, WY
• Providers in Riverton, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.