Larson Dean Walton, BA,AA,AA,AA,AA,AA,AA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1308 Cradduck Rd
Ada, OK 74820-8442

Phone

(580) 332-3699

Fax

(580) 332-9828

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Arts, Bachelor of Arts

Practice roles

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.

• State of Oklahoma

  • Skilled Nursing Facility
  • Talihina, OK
  • NPI 1154589430
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417172925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 CRADDUCK RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748208442",
            "telephone_number": "580-332-3699",
            "fax_number": "580-332-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 CRADDUCK RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748208442",
            "telephone_number": "580-332-3699",
            "fax_number": "580-332-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "LARSON",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "BA,AA,AA,AA,AA,AA,AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenzi Ann Walls
• Karen Ruth Walters, RN
• Shelly D Walters, MD
• Jonathan Paul Walther, MD
• Connie Leann Walton, RN, LMT
• Tarra Ward
• Paul Franklin Warlick, D.O.
• Kristen Warnock, D.O.
• Clay Warren
• Jaycee Warren

• Case Manager/Care Coordinator in Ada, OK
• Providers in Ada, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.