NPIMap

Organization Active NPI

Douglas C. Walker D.O., P.C.

  • Family Medicine Physician
  • Garland, UT
National Provider Identifier
1306843750
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3592391204 Issued in UT
Legal business name
DOUGLAS C. WALKER D.O., P.C.
Practice address
300 W 1400 S
Garland, UT 84312-9393
Phone
(435) 257-3684
Fax
(435) 257-7554
NPI assigned
Jun 30, 2005
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Douglas C Walker, D.O.NPI 1821095142
Title
President
Phone
(435) 257-3684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3592391204 UT Primary

Addresses

Primary practice location

300 W 1400 S
Garland, UT 84312-9393

Mailing address

PO Box 278
Tremonton, UT 84337-0278
Phone (435) 257-3684

Other identifiers 1

IdentifierTypeStateIssuer
519969458039MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000940 UT Part B Supplier - Clinic/Group Practice 8729991070 Receives reassigned benefits from 3 practitioners
Practice locations: Garland, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1306843750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843370278",
            "telephone_number": "435-257-3684",
            "fax_number": "435-257-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 1400 S",
            "city": "GARLAND",
            "state": "UT",
            "postal_code": "843129393",
            "telephone_number": "435-257-3684",
            "fax_number": "435-257-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS C. WALKER D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-257-3684",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "3592391204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519969458039",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.