NPIMap

Individual provider Active NPI

John Edmond Walton, MD

  • Urology Physician
  • Greer, SC
National Provider Identifier
1376632703
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
6530 Issued in SC
Practice address
402 Memorial Drive Extension
Greer, SC 29651
Phone
(864) 877-0779
Fax
(864) 877-7801
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 6530 SC Primary

Addresses

Primary practice location

402 Memorial Drive Extension
Greer, SC 29651

Mailing address

402 Memorial Drive Extension
Greer, SC 29651
Phone (864) 877-0779

Other identifiers 2

IdentifierTypeStateIssuer
89133WFOtherNCMEDICAID
065306MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000128 SC Practitioner - Urology 4385547942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Florida College of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

402 Memorial Dr Ext
Greer, SC 29651-1800
Phone (864) 877-0779

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103
  • Advent Health Polk Hospital, Columbus, NC, CCN 341322
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score
62.65 of 100Reported as individual
Quality
25.3
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6530SCMDProfessional Counselor

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1376632703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MEMORIAL DRIVE EXTENSION",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29651",
            "telephone_number": "864-877-0779",
            "fax_number": "864-877-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MEMORIAL DRIVE EXTENSION",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29651",
            "telephone_number": "864-877-0779",
            "fax_number": "864-877-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "JOHN",
        "middle_name": "EDMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "6530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "89133WF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065306",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.