Walter Rudolph Wallingford, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

0101024223 Issued in VA

Practice address

2115 Executive Dr
Suite 6C
Hampton, VA 23666-2499

Phone

(757) 874-7246

Fax

(757) 826-9415

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hampton Roads Arthritis Center

  • Rheumatology Physician
  • Hampton, VA
  • NPI 1285889287
  Authorized official Same address or phone
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1427132695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 EXECUTIVE DR",
            "address_2": "SUITE 6C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662499",
            "telephone_number": "757-874-7246",
            "fax_number": "757-826-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 EXECUTIVE DR",
            "address_2": "SUITE 6C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662499",
            "telephone_number": "757-874-7246",
            "fax_number": "757-826-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLINGFORD",
        "first_name": "WALTER",
        "middle_name": "RUDOLPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101024223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006045847",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "541005350",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BLUE",
            "identifier": "002129",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "15635",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "15635",
            "identifier": "15635",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa G. Wallace-Davis, OD
• David Michael Wallace Sr., M.D.
• Felicia Lee Wallace, LCSW
• Selina Samantha Wallace
• Kenneth William Waller, M.D.
• Gloria Walters, M.D.
• Betty R. Walton, M.A. CCC-SLP
• Moses Walusimbi Sr.
• Terezita Wamalwa
• Barbara A Ward, LCSW

• Rheumatology Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Rheumatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.