Active NPI
Matthew P Walker, LD
- Registered Dietitian
- Waterville, ME
National Provider Identifier
1407511173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- TD1671
- Practice address
- 200 Kennedy Memorial Dr
Waterville, ME 04901-4526 - Phone
- (207) 861-3000
- NPI assigned
- Nov 7, 2021
- Last updated
- Nov 7, 2021
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | TD1671 | ME | Primary |
Addresses
Primary practice location
200 Kennedy Memorial Dr
Waterville, ME 04901-4526
Mailing address
200 Kennedy Memorial Dr
Waterville, ME 04901-4526
Phone (207) 861-3000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TD1671 | ME | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636243200000",
"number": "1407511173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 KENNEDY MEMORIAL DR",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014526",
"telephone_number": "207-861-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 KENNEDY MEMORIAL DR",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014526",
"telephone_number": "207-861-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "MATTHEW",
"middle_name": "P",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-07",
"last_updated": "2021-11-07",
"certification_date": "2021-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ME",
"license": "TD1671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterville, ME
- Wal-Mart Stores East, LP (Vision Center 30-2013)
- Michael Scott Waldron, RPH
- Rosalind R Waldron, MD
- Walgreen Eastern Co Inc (Walgreens #17156)
- Abby Friend Walker, D.C.
- Elizabeth Ward, LCPC
- Water's Edge Therapy Services, LLC (Mindful Journey Counseling)
- Waters Edge Therapy, Inc
- Waterville Anesthesia Associates, P.a.
- Waterville Audiology PC (Waterville Audiology)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.