Active NPI
Elliott Blair Walsh, O.D.
- Corneal and Contact Management Optometrist
- Fort Stewart, GA
National Provider Identifier
1548476195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 1215
- Practice address
- Winn Army Community Hospital - 1061 Harmon Ave
Ste 1D03
Ft. Stewart, GA 31314-5611 - Phone
- (912) 435-5696
- NPI assigned
- May 14, 2007
- Last updated
- Oct 14, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1215 | NC | |
| Corneal and Contact Management Optometrist | 152WC0802X | 1215 | NC | Primary |
Addresses
Primary practice location
Winn Army Community Hospital - 1061 Harmon Ave
Ste 1D03
Ft. Stewart, GA 31314-5611
Mailing address
1061 Harmon Avenue Ste 1D0
Winn Army Community Hospital-
Fort Stewart, GA 31314-5611
Phone (912) 435-5696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1215 | NC | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William C Henson OD PA | Optometrist | 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": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1548476195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVENUE STE 1D0",
"address_2": "WINN ARMY COMMUNITY HOSPITAL-",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145611",
"telephone_number": "912-435-5696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WINN ARMY COMMUNITY HOSPITAL - 1061 HARMON AVE",
"address_2": "STE 1D03",
"city": "FT. STEWART",
"state": "GA",
"postal_code": "313145611",
"telephone_number": "912-435-5696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "ELLIOTT",
"middle_name": "BLAIR",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1215",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NC",
"license": "1215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.