Scott M. Walters, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2041ATI Issued in OR

Practice address

1022 NW 6TH St
Grants Pass, OR 97526-1114

Phone

(541) 476-4545

Fax

(541) 479-5985

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: scottw@eyecaregroupofsouthernoregon.emadirect.md

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.

• Eye Care Group of Southern Oregon, LLC

  dba Eye Care Group

  • Optometrist
  • Grants Pass, OR
  • NPI 1306988787
  Medicare reassignment

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1649381906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 NW 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261114",
            "telephone_number": "541-476-4545",
            "fax_number": "541-479-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 NW 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261114",
            "telephone_number": "541-476-4545",
            "fax_number": "541-479-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "SCOTT",
        "middle_name": "M.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2041ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024448",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina K Wallace
• Kristina Marie Wallace, PA-C
• Kimberly L Waller, PA-C
• Walmart Inc. (Walmart Pharmacy 10-1834)
• Jeri Lou Walsh
• Jacob T Waltrip, LMT
• Paula Marie Warden, L. AC
• Alicia Shaevon Warner
• Allegra Nicole Warren
• Beth Warren, LMT

• Optometrist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.