Individual provider Active NPI

John Brian Walton

  • Personal Care Attendant
  • Moundsville, WV
National Provider Identifier
1508433186
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
87 Swierkos Dr
Moundsville, WV 26041-4209
Phone
(304) 843-0910
Fax
(304) 843-0910
NPI assigned
Jun 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X WV Primary

Addresses

Primary practice location

87 Swierkos Dr
Moundsville, WV 26041-4209

Mailing address

736 Doolin Run Rd
New Martinsville, WV 26155-7801
Phone (304) 843-0910

Other identifiers 2

IdentifierTypeStateIssuer
1255523494MedicaidWV
1821206228MedicaidWV

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

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1508433186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 DOOLIN RUN RD",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261557801",
            "telephone_number": "304-843-0910",
            "fax_number": "304-843-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SWIERKOS DR",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260414209",
            "telephone_number": "304-843-0910",
            "fax_number": "304-843-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "JOHN",
        "middle_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255523494",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821206228",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moundsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.