Jonathan P Walgama MD PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

Q3122 Issued in TX

Legal business name

JONATHAN P WALGAMA MD PA

Practice address

3209 4TH St Ste 100
Longview, TX 75605-5170

Phone

(903) 757-2020

Fax

(903) 465-4665

NPI assigned

Jun 18, 2017

Last updated

Jun 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Norberto Hernandez

Title

Office Manager

Phone

(903) 757-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Margaret E Littlejohn, MD

  • Ophthalmology Physician
  • Lubbock, TX
  • NPI 1649893496
  Medicare reassignment Care Compare group NPD
• Jonathan Pierce Walgama, M.D.

  • Ophthalmology Physician
  • Longview, TX
  • NPI 1477846871
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1487184867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 4TH ST STE 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 4TH ST STE 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055170",
            "telephone_number": "903-757-2020",
            "fax_number": "903-465-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN P WALGAMA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "NORBERTO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-757-2020"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q3122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8FF527",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346191501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwalgama@kandgmds.integrityemrdirect.com",
            "affiliation": "N",
            "endpointDescription": "Integrity",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3209 4th St Ste 100",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756055170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rashida Michelle Johnson, PA
• Virginia Johnson, SPEECH THERAPIST
• Wendy Lynn Johnson, RN
• Louis G. Johnston, LCDC
• Jonathan C. Lockhart, MD
• Jones Optical, PA (Vision Source)
• Cassie Jones, BCBA
• Dan C Jones, M.D.
• Gabriella Jones, RBT
• George Jones III, LCCD

• Ophthalmology Physician in Longview, TX
• Providers in Longview, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.