David Clayton Walthall, FNP, MSN, BSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.017198 Issued in IL

Practice address

1340 S Damen Ave
Chicago, IL 60608-1169

Phone

(312) 997-7200

NPI assigned

Feb 13, 2018

Sex

Male

Sole proprietor

Yes

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1619477965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "312-997-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTHALL",
        "first_name": "DAVID",
        "middle_name": "CLAYTON",
        "credential": "FNP, MSN, BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorna V Walters, D.P.M.
• Robert Walters, PHD
• Tija Walters
• Velma Jayne Walters, P.T.
• Victoria Walters, M.S. CCC-SLP
• Sharon Kathleen Waltham, LCSW
• Walton Radiology PC
• Brandi Walton
• Charlene Walton, MD
• Emily A Walton, MD, MPH

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.