NPIMap

Individual provider Active NPI

William P Walker III, MD

  • Internal Medicine Physician
  • Shallotte, NC
National Provider Identifier
1578564142
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9500754 Issued in NC
Practice address
712 Village Rd SW
Suite 206
Shallotte, NC 28470-3448
Phone
(910) 755-6232
Fax
(910) 755-5984
NPI assigned
Aug 9, 2005
Last updated
Aug 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9500754 NC Primary
Hospitalist Physician 208M00000X 9500754 NC

Addresses

Primary practice location

712 Village Rd SW
Suite 206
Shallotte, NC 28470-3448

Mailing address

PO Box 928
Shallotte, NC 28459-0928
Phone (910) 755-6232

Other identifiers 4

IdentifierTypeStateIssuer
304049MedicaidSC
561931514OtherNCUNITED HEALTHCARE
85373OtherNCBCBS
8985373MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080204000007 SC Practitioner - Internal Medicine 9436231180 Reassigns benefits to 1 organization
I20100224000874 NC Practitioner - Internal Medicine 9436231180 Receives reassigned benefits from 1 practitioner
Practice locations: Shallotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Brody School of Medicine at East Carolina University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9500754NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. Past Accepting new patients
Raleigh Durham Medical Group PA Internal Medicine Past Accepting new patients
William P Walker III Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 4

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1578564142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 928",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284590928",
            "telephone_number": "910-755-6232",
            "fax_number": "910-755-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 VILLAGE RD SW",
            "address_2": "SUITE 206",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703448",
            "telephone_number": "910-755-6232",
            "fax_number": "910-755-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9500754",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "9500754",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304049",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "561931514",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "85373",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985373",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.