Active NPI
Larry L Walther, P.A.
- Physician Assistant
- Miami, OK
National Provider Identifier
1609871987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 681
- Practice address
- 21 W Central Ave
Miami, OK 74354-6815 - Phone
- (918) 542-3900
- Fax
- (918) 542-3928
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 681 | OK | Primary |
Addresses
Primary practice location
21 W Central Ave
Miami, OK 74354-6815
Mailing address
5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (918) 540-7758
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100186200A | Medicaid | OK | |
| 200468380F | Medicaid | OK |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 681 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Orthopaedic Surgery Inc | Past | Accepting new patients | |
| Midwest Surgery Center, LLC | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- lwalther13911@direct.integrisok.com
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Joplin, MO
- NPI 1588617278
-
- Ambulatory Surgical Clinic/Center
- Joplin, MO
- NPI 1013963453
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582502400000",
"number": "1609871987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 N INDEPENDENCE AVE",
"address_2": "280",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731125556",
"telephone_number": "918-540-7758",
"fax_number": "918-540-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 W CENTRAL AVE",
"city": "MIAMI",
"state": "OK",
"postal_code": "743546815",
"telephone_number": "918-542-3900",
"fax_number": "918-542-3928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTHER",
"first_name": "LARRY",
"middle_name": "L",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2020-02-24",
"certification_date": "2020-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "681",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100186200A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200468380F",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.