Cody Allen Walter, DO, MPH, MSA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125086825 Issued in IL

Practice address

400 N 9TH St # 4a
Springfield, IL 62702-5310

Phone

(217) 545-8000

Fax

(217) 545-2303

NPI assigned

Jun 23, 2025

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: codywalter@siusm.allscriptsdirect.net

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.

• Board of Trustees of Southern Illinois University

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1417844184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19658",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949658",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 9TH ST # 4A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025310",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "CODY",
        "middle_name": "ALLEN",
        "credential": "DO, MPH, MSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125086825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• James Patrick Walsh, O.D.
• Jennifer L Walston, AGACNP-BC
• Jenna Walters, OTR/L
• Kaitlyn M Walters, MSN, WHNP-BC
• Walton Clinic of Chiropractic Inc
• Walton Clinic, LTD
• Adrian Paul Walton, DC

• Pediatrics Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.