John Walsh, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

71008427A Issued in IN

Practice address

621 Memorial Dr Ste 502
South Bend, IN 46601-1075

Phone

(574) 647-5875

Fax

(574) 647-5878

NPI assigned

Aug 17, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Aims, LLC

  • Psychiatry Physician
  • Bremen, IN
  • NPI 1376072785
  Medicare reassignment NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment NPD
• Beacon Medical Group Inc

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  • Trauma Surgery Physician
  • South Bend, IN
  • NPI 1174927131
  NPD
• Munster Medical Research Foundation Inc

  • Anesthesiology Physician
  • Munster, IN
  • NPI 1982653044
  NPD

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1316427560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "547-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 502",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011075",
            "telephone_number": "574-647-5875",
            "fax_number": "574-647-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JOHN",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71008427A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021695",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Paule Walker, COTA/L
• Lynne Walker, MS
• Natalie Walker, OD
• Pam Walkowski, P.T.A.
• Amber Michelle Wallace, NP
• Mark M Walsh, MD
• Charlotte Em Walshe, MS
• Walter J Filipek MD
• Harrison Glen Walter, NP
• Doris Walterhouse, PT, DPT

• Acute Care Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Acute Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.