Active NPI
Diane L Walker, OD
- Optometrist
- Richland Center, WI
National Provider Identifier
1487607248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2570-035
- Practice address
- 100 N Main St
Richland Center, WI 53581-2237 - Phone
- (608) 647-8995
- Fax
- (608) 647-2569
- NPI assigned
- May 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2570-035 | WI | Primary |
Addresses
Primary practice location
100 N Main St
Richland Center, WI 53581-2237
Mailing address
705 S University Ave
Ste 510
Beaver Dam, WI 53916-3081
Phone (920) 885-8551
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38591400 | Medicaid | WI | |
| 8070 | Other | WI | DEAN HEALTH INSURANCE |
| 1006556 | Other | WI | PHYSICIANS PLUS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2570-035 | WI | MD | Optometrist |
| 2570 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487607248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 S UNIVERSITY AVE",
"address_2": "STE 510",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163081",
"telephone_number": "920-885-8551",
"fax_number": "920-885-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MAIN ST",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535812237",
"telephone_number": "608-647-8995",
"fax_number": "608-647-2569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DIANE",
"middle_name": "L",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2570-035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38591400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "8070",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS",
"identifier": "1006556",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland Center, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.