Kevin D Walter, MD

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

41518-020 Issued in WI

Practice address

3365 S 103Rd St
Greenway Medical Center
Milwaukee, WI 53227-4161

Phone

(414) 604-7501

Fax

(414) 604-7506

NPI assigned

Jun 29, 2006

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 WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwalter5768@direct.chw.org

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1316975089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST",
            "address_2": "GREENWAY MEDICAL CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-604-7501",
            "fax_number": "414-604-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST",
            "address_2": "GREENWAY MEDICAL CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-604-7501",
            "fax_number": "414-604-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "41518-020",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "WI",
            "license": "41518-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316975089",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Frances Walsh
• Ryan Dennis Walsh, MD
• Susan K. Walsh, LCSW
• Jeffrey Walter, LAT, ATC
• Kathy Walter, LPC
• Walter'S Second Chance of Milwaukee, LLC.
• Elizabeth Walters, DO
• Jana Susanne Walters, M.A., CCC-SLP
• Jennifer Lee Walters, PA-C
• Robert Walters

• Pediatric Sports Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Sports Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.