Randall Wayne Walters, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22354 Issued in WV

Practice address

22 Fleming Dr
Harts, WV 25524-9788

Phone

(304) 855-4595

Fax

(304) 855-9377

NPI assigned

Apr 25, 2006

Last updated

May 29, 2015By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Merit-based Incentive Payment System (MIPS)

Final score

96.26 of 100Reported as group

Quality

83.59

Improvement activities

40

Cost

90.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwwalters@knox.direct.csshealthtech.com

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.

• Green Valley Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1720755739
  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment NPD
• Southern Medical Partners, LLC

  • Emergency Medicine Physician
  • Hazard, KY
  • NPI 1538109962
  Medicare reassignment NPD
• Knox Hospital Corporation

  dba Knox County Hospital

  • Critical Access Hospital
  • Barbourville, KY
  • NPI 1407939515

  Family Medicine

  NPD
• Valley Health Systems, Inc.

  dba Valley Health Poca High School Health Center

  • Pediatrics Physician
  • Poca, WV
  • NPI 1215203500
  NPD (past)
• Garfield County

  dba Bryce Valley Clinic

  • Rural Health Clinic/Center
  • Cannonville, UT
  • NPI 1013119155
  NPD (past)
• Garfield County

  dba Garfield Mobile Cinic

  • Clinic/Center
  • Panguitch, UT
  • NPI 1598200297
  NPD (past)
• Garfield County

  dba Kazan Ivan W. Memorial Clinic

  • Rural Health Clinic/Center
  • Escalante, UT
  • NPI 1619179751
  NPD (past)
• Garfield County

  dba Circleville Clinic

  • Rural Health Clinic/Center
  • Circleville, UT
  • NPI 1649472796
  NPD (past)
• Rural Health Resources of Jackson Co Inc

  dba Family Practice Associates

  • Rural Health Clinic/Center
  • Holton, KS
  • NPI 1639145204

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1427014794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FLEMING DR",
            "city": "HARTS",
            "state": "WV",
            "postal_code": "255249788",
            "telephone_number": "304-855-4595",
            "fax_number": "304-855-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "RANDALL",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "22354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P01128276",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005193",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Health Systems Inc (Valley Health Harts)
• Valley Health Systems Inc (Valley Health Harts Pre K Thru Intermediate Health Center)
• Valley Health Systems, Inc (Valley Health Harts Pharmacy)
• Valley Health Systems, Inc. (Valley Health Harts PreK-Intermediate School Health Center)
• Canvas Ann Vannatter
• Patricia Watts
• Samantha Watts
• Roxie Opal Workman
• Sandra Workman

• Family Medicine Physician in Harts, WV
• Providers in Harts, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.