Gary P Walker OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-0539 Issued in ID

Legal business name

GARY P WALKER OD PC

Practice address

1067 Eastland Dr
Twin Falls, ID 83301-6747

Phone

(208) 733-1944

Fax

(208) 734-4984

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jared P Walker, O.D.NPI 1558490698

Title

President

Phone

(208) 733-1944

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eastland Vision Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jared P. Walker, O.D.

  • Optometrist
  • Twin Falls, ID
  • NPI 1558490698
  Medicare reassignment Care Compare group Authorized official
• Rustin M Hatch, O.D.

  • Optometrist
  • Twin Falls, ID
  • NPI 1265402911
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1477657013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016747",
            "telephone_number": "208-733-1944",
            "fax_number": "208-734-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016747",
            "telephone_number": "208-733-1944",
            "fax_number": "208-734-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY P WALKER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-733-1944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-0539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477657013",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806642800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastland Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eva Marie Garcia
• Jennifer Anne Gardner
• Theodore Gardner, PH.D.
• Paul Richard Garn, LCPC
• Stephanie Garrison, RN
• Jessica Gaston, LPC
• Geddes LLC
• Jeff Geist, DDS
• Gem Prep: Twin Falls LLC
• Gem State ENT, PLLC

• Optometrist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.