Individual provider Active NPI

Walter Lee King Jr., OD

  • Optometrist
  • Hickory, NC
National Provider Identifier
1639162597
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1831 Issued in NC
Practice address
336 10TH Ave NE
Hickory, NC 28601-3834
Phone
(828) 322-4973
Fax
(828) 322-1636
NPI assigned
Aug 25, 2005
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1831 NC Primary

Addresses

Primary practice location

336 10TH Ave NE
Hickory, NC 28601-3834

Mailing address

336 10TH Ave NE
Hickory, NC 28601-3834
Phone (828) 322-4973

Other identifiers 1

IdentifierTypeStateIssuer
89093GTMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100524000509 NC Practitioner - Optometry 1355470766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

336 10TH Ave NE
Hickory, NC 28601-3834
Phone (828) 322-4973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1831NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Viewmont Optometry PLLC Optometrist CurrentSince Jun 21, 2021 Accepting new patients
Walter L. King, MD Optometrist Past Accepting new patients

Locations

336 10th Ave NE
Hickory, NC 28601
Phone (828) 322-4327

Interoperability endpoints

  • Direct secure messaging: wally@eyeclinicdirect.net

Organizations & group practices 2

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1639162597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 10TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013834",
            "telephone_number": "828-322-4973",
            "fax_number": "828-322-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 10TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013834",
            "telephone_number": "828-322-4973",
            "fax_number": "828-322-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "WALTER",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093GT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.