Active NPI
Walter Thomas Lawrence, M.D.
- Plastic and Reconstructive Surgery Physician
- Iowa City, IA
National Provider Identifier
1508979139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 38784
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1007 - Phone
- (319) 384-9961
- Fax
- (319) 353-6511
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 04-28457 | KS | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 38784 | IA | Primary |
| Surgery Physician | 208600000X | 38784 | IA |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1007
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1007
Phone (319) 384-9961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100348020A | Medicaid | KS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38784 | IA | MD | Plastic and Reconstructive Surgery Physician |
| 04-28457 | KS | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264377600000",
"number": "1508979139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421007",
"telephone_number": "319-384-9961",
"fax_number": "319-353-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421007",
"telephone_number": "319-384-9961",
"fax_number": "319-353-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "WALTER",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2010-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "KS",
"license": "04-28457",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IA",
"license": "38784",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "38784",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100348020A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.