NPIMap

Individual provider Active NPI

Charles J. Walker, DO

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1437153095
Registry record updated Sep 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35362-021 Issued in WI
Practice address
3660 Guion Rd
Indianapolis, IN 46222-1697
Phone
(317) 920-7139
Fax
(317) 920-7229
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35362-021 WI Primary
Diagnostic Radiology Physician 2085R0202X 02004140A IN
General Practice Physician 208D00000X 02004140A IN

Addresses

Primary practice location

3660 Guion Rd
Indianapolis, IN 46222-1697

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805
Phone (317) 621-7584

Other identifiers 3

IdentifierTypeStateIssuer
30064200MedicaidWI
P01424274OtherINRAIL ROAD PTAN
201136420MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35362-021WIMDDiagnostic Radiology Physician
02004140AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Radiologists SC Diagnostic Radiology Past Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology Past Accepting new patients
Aurora Medical Center of Oshkosh, Inc Past Accepting new patients
Dean Health Systems, Inc, Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443312000000",
    "number": "1437153095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805",
            "telephone_number": "317-621-7584",
            "fax_number": "317-957-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 GUION RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221697",
            "telephone_number": "317-920-7139",
            "fax_number": "317-920-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CHARLES",
        "middle_name": "J.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2015-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "35362-021",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "02004140A",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02004140A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30064200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD PTAN",
            "identifier": "P01424274",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201136420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2015; 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.