Individual provider Active NPI

Marvin Dean Walker, D.O.

  • Diagnostic Radiology Physician
  • Clive, IA
National Provider Identifier
1609833102
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
02204 Issued in IA
Practice address
12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone
(515) 226-9810
Fax
(515) 226-8408
NPI assigned
Apr 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 02204 IA Primary

Addresses

Primary practice location

12368 Stratford Dr
Suite 300
Clive, IA 50325-8162

Mailing address

153 37TH St
Des Moines, IA 50312-4303
Phone (515) 277-0753

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000186 IA Practitioner - Diagnostic Radiology 0941294813 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4967OHMDPsychologist
02204IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince Dec 28, 2018 Accepting new patients
BTX Iowa Inc CurrentSince Sep 1, 2015 Accepting new patients
Diagnostic Imaging of in PC Diagnostic Radiology Past Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Organizations & group practices 3

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609833102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 37TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124303",
            "telephone_number": "515-277-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR",
            "address_2": "SUITE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258162",
            "telephone_number": "515-226-9810",
            "fax_number": "515-226-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARVIN",
        "middle_name": "DEAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "02204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.