Charles Raymond Walker, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

24103 Issued in TX

Practice address

2737 S Broadway Ave
Tyler, TX 75701

Phone

(903) 592-6000

Fax

(903) 592-3224

NPI assigned

Aug 9, 2007

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles R Gordon MD PAGroup PAC ID 8729992052, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.walker.p1@direct.precisionspinecare.nextgenshare.com

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.

• Charles R Gordon MD PA

  dba Precision Spine Care

  • Neurological Surgery Physician
  • Tyler, TX
  • NPI 1982717955
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment
• Charles R Gordon MD PA

  dba Precision Spine Care

  • Interventional Pain Medicine Physician
  • Lufkin, TX
  • NPI 1720513328
  NPD
• C.a.S.E. Management Associates, Inc

  • Mental Health Counselor
  • Tyler, TX
  • NPI 1588858302
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1609068071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6605",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116605",
            "telephone_number": "903-592-6000",
            "fax_number": "903-592-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-592-6000",
            "fax_number": "903-592-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11937 US Highway 271",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757083154",
            "country_code": "US",
            "telephone_number": "903-877-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "24103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co. (Walgreens #21535)
• Walgreen Co. (Walgreens Central Fill #1418-M)
• Angus Don Walker, PHD.
• Carmelia Walker
• Cassidy Walker
• Christie L Walker, M.D.
• Gwen Walker, M.S
• Heather Brooke Walker
• Jan Maedgen Walker, LPC
• John Everett Walker

• Clinical Neuropsychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.