Active NPI
Vance A. Walker
- Counselor
- Crestview, FL
National Provider Identifier
1619418886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMH13742
- Practice address
- 259 E Oakdale Ave
Crestview, FL 32539-3547 - Phone
- (850) 689-1234
- NPI assigned
- Mar 20, 2017
- Last updated
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMH13742 | FL | Primary |
Addresses
Primary practice location
259 E Oakdale Ave
Crestview, FL 32539-3547
Mailing address
259 E Oakdale Ave
Crestview, FL 32539-3547
Phone (850) 689-1234
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH13742 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1619418886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E OAKDALE AVE",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325393547",
"telephone_number": "850-689-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E OAKDALE AVE",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325393547",
"telephone_number": "850-689-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "VANCE",
"middle_name": "A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "IMH13742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.