Sean Paul Waldron, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

31792 Issued in ID

Practice address

1070 Hiline Rd Ste 210
Pocatello, ID 83201-2947

Phone

(208) 478-9081

Fax

(208) 478-4999

NPI assigned

Mar 7, 2012

Last updated

Mar 7, 2012By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1609140722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1597 SUMMER WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048258",
            "telephone_number": "208-522-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 HILINE RD STE 210",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012947",
            "telephone_number": "208-478-9081",
            "fax_number": "208-478-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "SEAN",
        "middle_name": "PAUL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "31792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ananda Walaliyadda, M.D.
• Hemantha Naveen Walaliyadda, MD
• Praveen Anuradha Walaliyadda, MD
• Ranmali Kalyani Walaliyadda, PAC
• Stephanie Theresa Walbridge, MS, PA-C
• Shayna Waldron, SLP
• Walgreen Co (Walgreens #06380)
• Bradley L Walker
• David J Walker
• Kris M Walker, MD

• Social Worker in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.