Individual provider Active NPI

Walter Mauriece Cheney, CPO LPO

  • Orthotist
  • El Paso, TX
National Provider Identifier
1538376108
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
101161 Issued in TX
Practice address
3901 Montana Ave Ste C
El Paso, TX 79903-4507
Phone
(915) 566-3440
Fax
(915) 566-1485
NPI assigned
May 16, 2007
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 16 TX
Orthotist 222Z00000X 101161 TX Primary

Addresses

Primary practice location

3901 Montana Ave Ste C
El Paso, TX 79903-4507

Mailing address

8630 Hickory Dr
Anthony, TX 79821-9275
Phone (915) 474-7216

Other identifiers 2

IdentifierTypeStateIssuer
178724401MedicaidTX
16OtherTXTEXAS BOARD OF O&P

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

LicenseStateTypeSpecialty
16TXMDProsthetics Case Management
101161TXMDOrthotist

Practice roles

OrganizationSpecialtyStatusNew patients
Custom Orthotics & Prosthetics, LP Orthotist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1538376108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 HICKORY DR",
            "city": "ANTHONY",
            "state": "TX",
            "postal_code": "798219275",
            "telephone_number": "915-474-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MONTANA AVE STE C",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034507",
            "telephone_number": "915-566-3440",
            "fax_number": "915-566-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEY",
        "first_name": "WALTER",
        "middle_name": "MAURIECE",
        "credential": "CPO LPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": "16",
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "TX",
            "license": "101161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178724401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF O&P",
            "identifier": "16",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.