Individual provider Active NPI

Walter K Meeker, M.D.

  • Internal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1295727774
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301056389 Issued in MI
Practice address
3643 W Front St
Suite C
Traverse City, MI 49684
Phone
(231) 935-0614
Fax
(231) 935-0832
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301056389 MI Primary

Addresses

Primary practice location

3643 W Front St
Suite C
Traverse City, MI 49684

Mailing address

3643 W Front St
Suite C
Traverse City, MI 49684-7759
Phone (231) 935-0614

Other identifiers 1

IdentifierTypeStateIssuer
104651842MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040922000288 MI Practitioner - Internal Medicine 8426026477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Michigan Medicine and Pediatrics PLLCGroup PAC ID 0345218392, 6 clinicians

Practice addresses (Care Compare)

3643 W Front St
Suite C
Traverse City, MI 49684-7760
Phone (231) 935-0614

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301056389MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: walter.meeker@nmmp.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1295727774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 W FRONT ST",
            "address_2": "SUITE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847759",
            "telephone_number": "231-935-0614",
            "fax_number": "231-935-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 W FRONT ST",
            "address_2": "SUITE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-0614",
            "fax_number": "231-935-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKER",
        "first_name": "WALTER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301056389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104651842",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.