Active NPI
Earl Thomas Walter, DO
- Family Medicine Physician
- Iola, KS
National Provider Identifier
1326003757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 05-16916
- Practice address
- 401 S Washington Ave
Iola, KS 66749-3256 - Phone
- (620) 365-6933
- Fax
- (620) 365-8126
- NPI assigned
- Apr 19, 2006
- Last updated
- Sep 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05-16916 | KS | Primary |
Addresses
Primary practice location
401 S Washington Ave
Iola, KS 66749-3256
Mailing address
PO Box 764
Wichita, KS 67201-0764
Phone (620) 365-6933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100098460 B | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-16916 | KS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378252800000",
"number": "1326003757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 764",
"city": "WICHITA",
"state": "KS",
"postal_code": "672010764",
"telephone_number": "620-365-6933",
"fax_number": "620-365-8126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S WASHINGTON AVE",
"city": "IOLA",
"state": "KS",
"postal_code": "667493256",
"telephone_number": "620-365-6933",
"fax_number": "620-365-8126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "EARL",
"middle_name": "THOMAS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2013-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "05-16916",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100098460 B",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iola, KS
- Shane Venteicher, ATC, LAT
- Vernon G. Lee, D.D.S., PA
- Ashlin M Wait
- Shane Patrick Walden, PHARMD
- Walmart Inc. (Walmart Pharmacy 10-1187)
- Charles Joseph Wanker, MD
- WB Real Estate of Iola, LLC (Greystone Residential Care Community)
- Elizabeth R Wehlage, RDH
- Travis Lynn West, PA-C
- Jaime M Westervelt, LAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.