Walter A Parham, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036112518 Issued in IL

Practice address

2 Good Samaritan Way
Suite 220
Mount Vernon, IL 62864-2408

Phone

(618) 899-3900

Fax

(618) 899-4786

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Interventional Cardiology

Education

University of Missouri, Columbia School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians

Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

St Marys Hospital Centralia IllinoisGroup PAC ID 6709788920, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
• Franklin Hospital Hospital, Benton, IL, CCN 141321
• Washington County Hospital Hospital, Nashville, IL, CCN 141308
• Hamilton Memorial Hospital Hospital, McLeansboro, IL, CCN 141326

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment Care Compare group NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196

  Interventional Cardiology

  Medicare reassignment Care Compare group NPD
• Good Samaritan Regional Health Center

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment Care Compare group
• St. Mary'S Hospital, Centralia, Illinois

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Centralia, IL
  • NPI 1710105192
  NPD
• Good Samaritan Regional Health Center

  • Rehabilitation Hospital Unit
  • Mount Vernon, IL
  • NPI 1043270424
  NPD (past)
• River to River Heart Group, LLC

  • Internal Medicine Physician
  • Marion, IL
  • NPI 1336168491

  Cardiovascular Disease

  NPD (past)
• St. Mary'S Hospital

  • Rural Health Clinic/Center
  • Vandalia, IL
  • NPI 1790789451
  NPD (past)
• Mercy Support Services

  • Clinic/Center
  • Saint Louis, MO
  • NPI 1265572812
  NPD (past)
• Metro Heart Group of St. Louis, Inc.

  • Specialist
  • Festus, MO
  • NPI 1487650545
  NPD (past)
• St. John'S Mercy Support Services

  • Cardiovascular Disease Physician
  • Washington, MO
  • NPI 1912020397
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franklin Hospital District

  • Critical Access Hospital
  • Benton, IL
  • NPI 1699778951
  Care Compare affiliation
• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• Hamilton Memorial Hospital District

  • Critical Access Hospital
  • MC Leansboro, IL
  • NPI 1447257258
  Care Compare affiliation
• Hamilton Memorial Hospital District

  • Rural Health Clinic/Center
  • Carmi, IL
  • NPI 1588902183

  Hospital

  Care Compare affiliation
• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation
• Washington County Hospital District

  • Rural Health Clinic/Center
  • Nashville, IL
  • NPI 1316555816

  Hospital

  Care Compare affiliation
• Washington County Hospital District

  • Critical Access Hospital
  • Nashville, IL
  • NPI 1659321560
  Care Compare affiliation

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487646972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY",
            "address_2": "SUITE 220",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642408",
            "telephone_number": "618-899-3900",
            "fax_number": "618-899-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY",
            "address_2": "SUITE 220",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642408",
            "telephone_number": "618-899-3900",
            "fax_number": "618-899-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "WALTER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036112518",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036112518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0010032059",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112518",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wparham28176@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wparham28176@direct-ehr-ssmhc.com",
            "address_1": "2 Good Samaritan Way",
            "address_2": "Suite 220",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Good Samaritan Way",
            "address_2": "Suite 220",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yagnesh V. Oza, M.D.
• Miko Emmanuel Peralta Palad, DPT
• Palladian Mt Vernon SNF LLC
• Jacques Papazian, M.D.
• Michaela Parchman, FNP-C
• Deidra Dawn Parks, M.S. CCC/SLP
• Shannon D Parks, APN
• Neetin C Patel, MD
• Pathways Counseling and Consultation PLLC
• Jarod Allen Payne, LCSW

• Cardiovascular Disease Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.