Individual provider Active NPI

James M Walter Jr., DDS MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Winston Salem, NC
National Provider Identifier
1356364533
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4128 Issued in NC
Practice address
3020 Maplewood Ave
Winston Salem, NC 27103-4012
Phone
(336) 768-9881
Fax
(336) 768-6066
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 4128 NC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4128 NC Primary

Addresses

Primary practice location

3020 Maplewood Ave
Winston Salem, NC 27103-4012

Mailing address

3020 Maplewood Ave
Winston Salem, NC 27103-4012
Phone (336) 768-9881

Other identifiers 1

IdentifierTypeStateIssuer
8998854MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090812000644 NC Practitioner - Oral Surgery 5890849756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Walter & Ringeman, P.a. Oral and Maxillofacial Pathology CurrentSince Jan 1, 2014 Accepting new patients

Locations

222 W Main St
Elkin, NC 28621
Phone (336) 835-5006

3020 Maplewood Ave
Winston Salem, NC 27103
Phone (336) 768-9881

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1356364533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034012",
            "telephone_number": "336-768-9881",
            "fax_number": "336-768-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034012",
            "telephone_number": "336-768-9881",
            "fax_number": "336-768-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NC",
            "license": "4128",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "4128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8998854",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.