Individual provider Active NPI

Edward J Walko, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Norfolk, VA
National Provider Identifier
1396773263
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0102049902 Issued in VA
Practice address
5665 Lowery Rd
Suite 100
Norfolk, VA 23502-2220
Phone
(757) 422-2966
Fax
(757) 422-4563
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0102049902 VA Primary

Addresses

Primary practice location

5665 Lowery Rd
Suite 100
Norfolk, VA 23502-2220

Mailing address

5665 Lowery Rd
Suite 100
Norfolk, VA 23502-2220
Phone (757) 422-2966

Other identifiers 4

IdentifierTypeStateIssuer
006800238MedicaidVA
2300033OtherUNITED HEALTH CARE
890616FMedicaidNC
400003OtherVABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20100427000283 VA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 6800808288 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102049902VAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walko Enterprise Incorporated Pain Medicine CurrentSince Jan 1, 2015 Accepting new patients

Locations

1133 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 496-2050

1788 Republic Rd
Virginia Beach, VA 23454
Phone (757) 640-8673

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1396773263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 LOWERY RD",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022220",
            "telephone_number": "757-422-2966",
            "fax_number": "757-422-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 LOWERY RD",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022220",
            "telephone_number": "757-422-2966",
            "fax_number": "757-422-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKO",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0102049902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006800238",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2300033",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890616F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "400003",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.