Individual provider Active NPI

Renee A Walker, DO

  • Pediatric Otolaryngology Physician
  • Joplin, MO
National Provider Identifier
1417949488
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
104366 Issued in MO
Practice address
1920 E 32ND St
Joplin, MO 64804-4103
Phone
(417) 781-4613
NPI assigned
Aug 16, 2005
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 104366 MO Primary

Addresses

Primary practice location

1920 E 32ND St
Joplin, MO 64804-4103

Mailing address

1920 E 32ND St
Joplin, MO 64804-4103
Phone (417) 781-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040917000026 MO Practitioner - Otolaryngology 1052389178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otolaryngology of JoplinGroup PAC ID 1153340278, 4 clinicians

Practice addresses (Care Compare)

1920 E 32ND St
Joplin, MO 64804-4103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104366MOMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology of Joplin CurrentSince Jun 1, 2011 Accepting new patients
Hand and Microsurgery Associates, LLC Past Accepting new patients

Locations

1920 E 32nd St
Joplin, MO 64804
Phone (417) 621-9000

2620 Cunningham Ave
Joplin, MO 64804
Phone (417) 624-2621

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1417949488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044103",
            "telephone_number": "417-781-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044103",
            "telephone_number": "417-781-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "RENEE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MO",
            "license": "104366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.