Darrell Ray Walter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1125 Issued in FL

Practice address

107 Kingsway Rd
Brandon, FL 33510-4601

Phone

(813) 689-2222

Fax

(813) 689-0802

NPI assigned

Nov 6, 2006

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 FL

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1366511388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 KINGSWAY RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104601",
            "telephone_number": "813-689-2222",
            "fax_number": "813-689-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KINGSWAY RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104601",
            "telephone_number": "813-689-2222",
            "fax_number": "813-689-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "DARRELL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "19792",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared John Wallen, M.D.
• Rebecca Wallington
• Carey J Walls IV
• Darlene Walsh
• Kelly Walsh, LPTA
• Chad Waltz, DDS
• Wanda I. Nieves-Moreno, DC, LLC (Brandon Chiropractic and Massage)
• Wanderlust Experience (Home 2 Care)
• Kailyn Nicole Wapinsky, PA-C
• Randy Carl Warndahl

• Optometrist in Brandon, FL
• Providers in Brandon, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.