Active NPI
Walker P McVea, DDS
- Dentist
- Clinton, LA
National Provider Identifier
1568577013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2848
- Practice address
- 12236 Woodville St
Clinton, LA 70722 - Phone
- (225) 683-3384
- Fax
- (225) 683-3353
- NPI assigned
- Aug 21, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2848 | LA | Primary |
Addresses
Primary practice location
12236 Woodville St
Clinton, LA 70722
Mailing address
PO Box 96
12236 Woodville St
Clinton, LA 70722
Phone (225) 683-3384
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1828483 | Medicaid | LA | |
| F1242 | Other | LA | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2848 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568577013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 96",
"address_2": "12236 WOODVILLE ST",
"city": "CLINTON",
"state": "LA",
"postal_code": "70722",
"telephone_number": "225-683-3384",
"fax_number": "225-683-3353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12236 WOODVILLE ST",
"city": "CLINTON",
"state": "LA",
"postal_code": "70722",
"telephone_number": "225-683-3384",
"fax_number": "225-683-3353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCVEA",
"first_name": "WALKER",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "2848",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1828483",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "F1242",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.